









SHOCK AT THE 
FRONT 






WILLIAM TOWNSEND PORJER^ 



UNIVERSITY OF CALIFORNIA 
LOS ANGELES 




GIFT OF 

Mrs. F. B. ^limner 



. 



Shock at the Front 




w £ 



Shock at the Front 



By 
William Townsend Porter 




The Atlantic Monthly Press 
Boston 



Copyright, 1018, by 
THE ATLANTIC MONTHLY PRESS. INC. 



:m 






To 

A. S. P. 









BIOGRAPHICAL NOTE 

[After graduating from The Medical School 
of Washington University at St. Louis, 
William Townsend Porter took post-graduate 
courses at the Universities of Kiel, Breslau, 
and Berlin. He has been a teacher of physi- 
ology at St. Louis Medical College and at the 
Harvard Medical School, and has given much 
time and thought to the development of edu- 
cational apparatus designed to individualize 
the work of students, and render them less 
dependent upon the formal instruction of the 
lecture-room. Recognized as an authority on 
blood pressure, and as a man of ingenuity and 
shrewdness of mind, he was selected by the 
Rockefeller Institution to undertake the in- 
vestigations which he so interestingly de- 
scribes in the pages which follow.] 



SHOCK AT THE FRONT 

CHAPTER I 

In an upper room of a marble palace 
inscribed to the memory of Junius Spencer 
Morgan, 'a. merchant of Boston,' a dog 
lay dying of pneumonia. Without, the 
first glow of a July dawn faintly touched 
the great court of the Medical School. 
Within, the lights still burned, marking 
the shadows beneath the eyes of three 
men, sleepless for forty hours. They had 
kept their watch by day and night, from 
the moment at which the terrible Fried- 
lander bacillus had entered the bronchial 
tubes, until this present hour, the hour of 
death. They had seen the fever rise point 
by point, until the impersonal column 
touched io6°. They had seen these fires 
maintained and then, the toxines finally 
triumphant, the sudden wonderful fall to 



Shock at the Front 

below normal, — the fatal descensus Averni, 
— and now the coma, image and precursor 
of eternal sleep. 

Tired were these men, but happy. A 
smile was on their lips, in their eyes a rev- 
erent joy. For they saw before them a new 
Truth, shining, resplendent, born with the 
day, unknown since the beginning of time. 

In this dog, whose sacrifice had been so 
fruitful, the vagus nerves, the great 
strands that connect the lungs with the 
brain, had been painlessly severed before 
the disease began. There had never been 
a pneumonia like his. The furious respira- 
tion, — sixty, seventy, even eighty to the 
minute, — painful and exhausting, was ab- 
sent. In spite of the mortal inflammation 
of the lungs, the breathing of this poor 
vagrant had been from beginning to end 
as calm, as peaceful, as that of a dog 
lying on a rug before the fire. It was, 
then, through the vagus nerves, the nor- 
mal controllers of breathing, that the res- 
piratory storm of pneumonia was let loose. 



Shock at the Front 

This was a truth which threw a new light 
on the mechanism of the disease, enlarged 
our knowledge of normal respiration, and 
gave a lead for methods of relief hitherto 
unimagined. 

How far that seemed from the trenches ! 
But trust in the improbable underlies all 
creative effort. Hope, in this life the cap- 
ital of the poor and the medicine of the 
sad, rests on the unexpected. And most 
unexpected was the coming of a letter 
from the Rockefeller Institute for Medical 
Research, asking if I would consent to go 
to France to search for the cause of 'shock' 
and for a remedy. In half an hour I wired 
consent. After thirty months of thinking, 
controlled by rigid experimentation, on 
the one subject of pneumonia, the spring 
fret was strong in my blood, and the great 
game of war had a deep appeal. 

The disorder against which I was to 
take the field was not the mental derange- 
ment known as 'shell shock,' which comes 
typically without a wound, and is the 

3 



Shock at the Front 

result of an overwhelming jarring of the 
nervous system. My research would have 
to do with 'traumatic' shock, a condition 
seen only after certain injuries, the acci- 
dents of peace as well as of war. 

Shell shock is marked by strange paraly- 
ses, by protean negations of our ordinary 
powers. Some patients cannot speak. 
Others tremble at a touch or a sound, 
however gentle, as the leaves of the quiv- 
ering aspen tremble in the soothing airs 
of spring. Fabulous contractures appear 
— strong youths are bent into distorted 
figures like a rheumatic Nibelung. The 
human nerves cannot always withstand 
the vandal touch of war. The slow in- 
struction of uncounted ages is forgotten; 
the measured harmony of functions is 
destroyed ; the bonds of the physical body 
politic are broken — confusion reigns, and 
groups of muscles, mere hewers of wood, 
freed from the long control of the intelli- 
gent brain, show forth unbridled strength 
in powerful but uncouth forms. 

4 



Shock at the Front 



Compared with this swash-buckling 
malady, traumatic shock is a sober, seri- 
ous disease. In traumatic shock, the pa- 
tient is utterly relaxed, pale as the dead, 
with eyes like those of a dead fish; he is 
apparently, but not really, unconscious; 
his breathing is shallow and frequent, his 
heart-beat rapid and feeble, and his 
pulse scarcely to be felt at the wrist. 
Much of the blood has collected in the 
great veins, the heart is poorly filled, the 
driving pressure of the blood in the arte- 
ries is less than half the normal — too low 
for the maintenance of a proper circula- 
tion of blood to the brain ; the brain-cells 
suffer for lack of food. 

Men rarely die of shell shock. The 
methods of cure are sometimes as inter- 
esting as the disease itself. In the summer 
of 1 91 6, there was a spirited discussion 
among the French as to the right of a 
soldier to refuse treatment for shell shock. 
The treatment in question was directed 
against the deformities resulting from the 

5 



Shock at the Front 

continued contraction of certain groups 
of muscles. A soldier, bent like a rag- 
picker searching in the dust of Mont- 
martre, was grasped under each arm by a 
stout assistant surgeon. To the muscles 
opposing the contracted group, the chief 
surgeon then applied a strong electric cur- 
rent in such a way that the resultant con- 
traction would inevitably cause the pa- 
tient to straighten up. The instant this 
occurred, the assistants walked ofT with 
the astonished patient, now in the erect 
position. The malign spell was broken. 
The patient saw that he could stand erect, 
and the battle was won. 

The electric current used was irritating 
and certainly surprising, but it was not 
dangerous, or even very painful. Cures 
were man}', and the method got into the 
newspapers. There it was called 'torpe- 
doing.' Phrases may be more harmful 
than artillery fire. They should rightly 
be detained until their virus is measured. 
This phrase worked mischief. 

6 



Shock at the Front 

One day there came a soldier who re- 
fused to be torpedoed. The chief surgeon 
insisted. The patient struck out wildly. 
From words they came, alas, to blows! 
The surgeon was an educated man; he 
had defended a Thesis; he knew la boxe; 
he was versed in what Littre terms the 
pagilat anglais. And, since knowledge is 
power, he prevailed — without electricity. 
The result was a resounding scandal, and 
the complete cure of the patient. The 
affair came at length before the Academy. 
It was decided that a soldier should suffer 
the surgeon, as a patriotic duty. 

Men rarely die of shell shock, but trau- 
matic shock is usually fatal when skilled 
assistance is not at hand. Not less than 
twenty thousand men are dying each year 
of traumatic shock in the English and 
French armies. 

Surgeons had long recognized this ca- 
lamitous condition as a formidable ad- 
versary. The cause of the disease was 
unknown. There had been many hypoth- 

7 



Shock at the Front 

eses; the two most important survived for 
more than a generation. One of these 
hypotheses declared that shock was due 
to the exhaustion of the brain-cells which 
regulate the blood-flow by controlling the 
bore of the small arteries; the other dis- 
covered the cause of shock in the irritation 
of the sensory nerves. Both these hypoth- 
eses I had overthrown by experiments in 
the laboratories of the Harvard Medical 
School. It was these investigations which 
procured for me the opportunity to study 
shock at the front in this war. 

The remedies for shock left much to be 
desired. It was the hope of those who 
sent me, that some new remedy might be 
found. 

My adventures in the search for the 
cause of shock and for a remedy are set 
forth in these pages. 

Candid friends will urge that the book 
must have at least one merit: it has set 
bounds to the growth of a traveler's tale 
— a virtue of the printed page not suffi- 

8 



Shock at the Front 

ciently celebrated. In my case, let me 
hasten to declare, the implied suspicion 
is unfounded. The picture is painted 
as the author saw it. More than thirty 
years of experimentation have taught me 
to love the sweet security of facts. Sweet 
they undoubtedly are to the friend of 
measured relationships — their security is 
another matter. The world is after all 
nur Schein und Vorstellung — the half- 
lit shadow of the mind. 



CHAPTER II 

We were off the coast of France. It 
was a caressing day. The sun sank into 
the western wave with a splendid compe- 
tence, the result of long practice. Our last 
sunset, perhaps. The ports were sealed. 
No lights were shown. The boats were 
swung out — their covers off, the davits 
greased, food and the precious water-keg 
in place. The gun crew stood to quar- 
ters. Full speed ahead. 

I decided to stay on deck until we 
reached the mouth of the Gironde. Many 
of the passengers were of the same mind. 
My cabin was in the lowest tier, and if we 
should hit a mine, minutes might count. 
At 4 A.M., we picked up a magnificent 
revolving light; before long, two other 
first-class lights, turning on the horizon 
from the top of ghostly towers. Pres- 

10 



Shock at the Front 

ently, we saw a powerful beam searching 
the waves. Its dazzling glare rested on 
the ship, moving with us. For many 
minutes we endured an almost shameful 
publicity. 

The East was now lighted for the com- 
ing of the day. Anchored vessels bor- 
dered the fairway. Their hulls were black 
against a tone of silver gray; admirable 
motive for the etched plate. So lay the 
black ships of the Greeks, on another sea, 
in those Trojan days when the causes of 
war were easier to understand. 

The approach to the river is very fine: 
the Gironde is handsomely dressed for her 
bridal with the sea. At 7 a.m. we were 
gliding along the narrow stream through 
fields green with the promised harvest. 

It was time for the dreaded inquisition. 
Were our papers correct? Would we be 
allowed to land? The passengers were 
much disturbed. We were packed, some 
hundred of us, in the vestibule leading to 
the dining-saloon. There we stood, the 

11 



Shock a t the Front 

strong and the infirm, for two long hours. 
I was jammed against two young girls who 
were going out for the Red Cross. Con- 
versation began, due to the strong play of 
natural forces. You remember my Uncle 
Toby. My Uncle Toby found the Widow 
Wadman's eye very compelling. But 
Laurence Sterne was a clergyman. Had 
he been a scientist, he would have ob- 
served that the power of the Widow Wad- 
man's eye was inversely as the distance. 
Now, the distance of these ladies from my 
ear was the same as the distance of the 
Widow Wadman's eye from my Uncle 
Toby — about five inches. The power 
exerted was therefore twenty times as 
great as if the social insulation had been 
the usual hundred inches. There can be 
no doubt that distance, mathematically 
speaking, is a 'function' of behavior. 

But this verges dangerously on reflec- 
tion; to mix thinking with conversation is 
to spoil two very good things. Well, 
nature could not be denied; the ladies 

12 



Shock at the Front 

began to talk. At a range of five inches, 
the execution was considerable. They 
told me, in these two hours, their opinion 
of Shelley and much of their past history; 
though, to be sure, when a woman talks of 
her past, she hasn't any. It was a curious 
friendship: it began, it ran its intimate, 
almost clandestine, course, and was fin- 
ished, within a radius of fifteen inches. 

From time to time, while these measure- 
ments were being collected, the door into 
the dining-saloon opened a crack and a 
wilted suspect was dragged in to confront 
five officials who spoke torrential French 
and dribbling English. By that hour, 
the more feebly engined passengers were 
suffering from what at the front would 
have been called shell shock. One man, 
born in Smyrna, a Greek by nationality, 
said he was a manufacturer in America. 
'What do you make?' he was asked. 'I 
make sickles.' — 'Sickles! Qu'est-ce que 
c'est que ca? Can you show us one? — 
' But certainly,' replied the flustered pas- 

13 



Shock at the Front 

senger. Whereupon he reaches into his 
pocket and fetches out — not a sickle, 
but a pack of playing cards, which it is 
forbidden to bring into France. Behold 
a Greek in a cold sweat ! The bystanders 
grin largely, and even the officials relax 
their severe gloom. 

After the good-natured ineptitude of the 
custom-house, I took a cab. The cab was 
ancient and groaned appealingly, but I 
presently found that the carnivora were 
modern. They had the unfailing mark of 
high efficiency; they had eliminated all 
lost motion. 

At the Hotel Bayonne, I got a large 
clean room, admirable cooking, and the 
true wine of Bordeaux. The bed seemed 
insecure; it was soft; it gave somewhat 
when my weight rested upon it; whereas 
my bed on the Rochambeau had been 
apparently founded on a rock. 

In spite of these suspicions, I had a 
pleasant walk in the town. The builders 
of the cathedral, with tender regard for 

14 



Shock at the Front 

the amateur of architecture, have com- 
bined an exquisite Gothic choir with a fine 
Romanesque nave. 

The statues in Bordeaux were not al- 
ways appealing, as works of art. But 
public monuments should be distinguished 
from works of art. The distinction is 
usually easy. Public monuments should 
be raised only to men who create in the 
mind an immense historic vibration, an 
emotion too profound to admit so small 
a matter as the ability of the relatively 
obscure artist. In such cases, it is a 
positive disadvantage to have the artistic 
question obtrusive. iEsthetically, it is a 
fault to have two points of supreme inter- 
est in the same composition. It is fitting 
that the statue of Bartolomeo Colleoni 
should be a great work of art ; but when I 
looked upon the statue of Vercingetoi ix, 
in Bordeaux, I saw the rush of the Arverni 
and heard the clash of Roman swords. 
Again high patriotism and dauntless cour- 
age went down before a deadly dull tech- 

15 



Shock at the Front 

nique. Caesar, when he murdered Ver- 
cingetorix, gave him deathless fame. To 
summon the dead is accounted a miracle, 
but to keep a dead Gaul alive for twenty 
centuries with a page or so of easy prose, is 
great indeed. 

I stood reverently at the tomb of 
Michael, Seigneur of Montaigne, where he 
lies in marble mail. He sleeps in an 
Academy — in the hall of entrance, a 
place of dignity. Life passes in review 
before him. As I watched, youths and 
maidens entered from the unknown, 
moved across the scene, now smiling, now 
anxious, and vanished on the farther side. 
They went to judgment, to account for 
the use of their talents. Their footsteps 
died away. I knew them no more. 

Epitome of our existence. We pass 
hurriedly from void to void, while the 
patient hills slowly wonder at our fever- 
ish inconstancy. 

Not so Montaigne. Deathless, incor- 
ruptible, he rests unchanged, while gen- 

16 



Shock at the Front 

erations break like waves against his 
pedestal. 

Were I a practicing physician, this 
appreciation of Montaigne would be mag- 
nanimous. He did not love practitioners. 
He quotes with approval Nicocles' ' Phy- 
sitians have this happe, that the sunne 
doth manifest their successe, and the 
earth doth cover their fault.' 

Therapeutics in Montaigne's time did 
not lack imagination. 'The very choyce 
of most of their drugges is somewhat 
mysterious and divine. The left foote of a 
tortoyze, the stale of a lizard, the dongue 
of an elephant, the liver of a mole, 
blood drawne from under the right wing 
of a white pigeon, some rattes pounded 
to small powder, and such other foolish 
trash, which rather seeme to be magike 
spells or charmes than effects of any 
solide science.' 

As I wandered in Bordeaux, I came 
upon a street named for Paul Bert. Paul 
Bert was a physiologist. On entering his 

17 



Shock at the Front 

street, there sprang into my mind the 
experiment devised by him to answer the 
important question whether a nerve will 
carry a message in a direction opposite to 
that ordinarily taken. In other words, 
will a nerve that usually carries impulses 
from the brain to the hand, carry them 
also from the hand to the brain? 

Paul Bert's method was ingenious. He 
made a small incision in the back of a rat. 
He then freshened the tip of the rat's tail 
and sewed the tip into the wound in the 
back. In a few days the tip had grown 
fast to the back and the wound was 
healed — the tail was attached at both 
ends. This accomplished, Bert severed 
the base of the admirable organ. In the 
third state of the tail, that which had been 
the tip was become the root; the tail 
was reversed; the erstwhile tip could no 
longer delicately explore its environment. 

What would happen? Would the for- 
mer base, now moving in a giddy and 
unaccustomed element, receive and trans- 

18 



Shock at the Front 

mit the throng of new sensations? It was 
an absorbing question. Absolutely with- 
out precedent. Our rat had never seen 
or even heard the like. Female relatives 
could not advise him by pointing out 
what father had done under similar cir- 
cumstances. 

Nor could aid be derived from his ex- 
tensive knowledge of the lower animals; 
unless, possibly, from the elephant, whose 
tail was so amusingly placed in front — no 
doubt, a temporary arrangement — while 
its true place was kept for it by an oth- 
erwise useless appendage. The elephant 
perhaps had been changed in his sleep, 
like our rat, who had sniffed a sweetish 
odor and had straightway fallen to dream- 
ing, from which dream he had waked to 
find his tail fast at a point he could 
neither see nor touch. He had had one 
recurrence of this attack. He dreaded 
another. His tail might be moving to a 
position on his nose. It would never do to 
look like an elephant — quite humiliating. 

19 



Shock at the Front 

The rat knew of course that the world 
was made for rats; every young rat com- 
mitted that to memory in his Sunday 
school. The other animals were inferior 
and for his use and pleasure. Each was 
of value according to its kind. Even 
man, one of the slowest and clumsiest of 
creatures, cruelly handicapped by the ab- 
sence of a tail, — a beast whose whiskers, 
scarcely sentient, obviously dying, were 
proof of rapidly approaching extinction, 
— even man had one delightful quality. 
As the source of a delicacy indispensable 
to gourmets, some means must be found 
of preventing his further decline. The 
sole producer of garbage could not be 
suffered to die out. 

But the world, so blessed with intoxi- 
cating odors, was difficult for cripples. 
What a reversed tail would do was a prob- 
lem especially serious to an animal whose 
love of privacy led him to prefer narrow 
passages beneath the earth. With his 
starboard whiskers touching one wall and 

20 



Shock at the Front 

his port whiskers touching the other, he 
could navigate a forward course with ease. 
If, by chance, he met an older and more 
distinguished rat, he could back to the 
next cross-passage, guided by his percep- 
tive tail. But now! Who could say? If he 
met a lady rat, and tried to back, without 
the aid of a tail, he w r ould probably tear 
his skin. To lose his integument in the 
presence of a lady would be embarrassing. 

These painful apprehensions were sud- 
denly set at rest by Paul Bert, who sharply 
pinched the free end of the tail, once the 
base, now the tip. The rat cried out. 
The observation was made. Nerves would 
transmit impulses in both directions. 

The rat cried out, but not from pain; 
nor from the rage which, as a gentleman, 
he naturally felt at such a liberty. No. 
He cried out for joy. 'Glorious!' he 
exclaimed; 'I have recovered l8o° of my 
sensory horizon. "There's a Divinity that 
shapes our ends, rough-hew them how we 
will." ' 

21 



Shock at the Front 

Cheered by these reflections, I sought 
my inn, well satisfied with a town which 
drives a roaring trade, drinks largely of a 
famous wine, and keeps in pious memory 
Vercingetorix, Montaigne, and Paul Bert. 

After a good night's sleep, I arrive 
at the station for Paris. The first-class 
ticket office is not open. Meanwhile, the 
train is filling. I buy a ticket at the mili- 
tary window. On the perron, the guard 
is surrounded by a clamorous crowd. 
He says that all the first-class compart- 
ments are reserved. I give him a franc. 
He finds that this monsieur has reserved 
a good place. I take it. The corridor 
fills with people who have paid first-class 
fares and have no seats. Alarums and 
excursions ! The spectacle of this misery 
imparts a special flavor to the fruit of 
corruption. I must overhaul my morals 
— when I get to Paris. The train leaves 
twenty-five minutes after the schedule. 

At ten o'clock, a dining-car is put on. 
The waiter says there are no seats, except 

22 



Shock at the Front 

at 1 1. 15 and 2.30, too early and too late. 
The solution is simple. I shall go with- 
out my lunch; I shall draw on my reserve 
calories. To my French companions I 
explain biologically about the camel and 
his useful stores. There is some laughter. 
I am informed that the camel has no so- 
cial status in France. Poor camel ! These 
cruel distinctions are repellent to a phys- 
iologist — almost impious. To be sure, the 
camel has a hump. Some camels have 
two. It is unfortunate. One hump is par- 
donable. It is, so to say, the animal's first 
offense. About the camel with two humps 
I am not sure. 

Opposite me is a man evidently in poor 
health — an intelligent kindly face, lined 
by premature old age. He has two col- 
lapsed air-cushions, but breath only for 
one. I blow up the second cushion. We 
fraternize. 

'You must know,' says he, 'that I am 
a Frenchman living in Canada. I have 
come over to be ready for my call. They 

23 



Shock at the Front 

have called the class of forty-seven. My 
age is fifty. Soon they will need me. Of 
course,' he adds, carefully adjusting the 
air-cushions to support his ailing back, 'of 
course, I cannot hope for the first line, but 
perhaps I can slip in just behind.' It is 
the celebrated French esprit. 



CHAPTER III 

We reach Paris at dusk. I go in a taxi 
to the Hotel des Saints Peres. I find 
this refuge of the Holy Fathers strategi- 
cally situated on the left bank, in the 
Quartier Latin, a neighborhood in which 
religious devotion is not always a work- 
ing hypothesis. The hotel is closed for 
the summer. Cest la guerre. What to 
do? I appealed to the cocker. I remem- 
bered a young English friend, also a physi- 
ologist, who believed himself defrauded by 
a Paris cab-driver. My colleague prided 
himself on his ability to swear in French. 
On this occasion, he displayed his full 
powers. When he paused, from exhaus- 
tion, the cocker made him a low bow and 
said, 'Monsieur, you speak French like 
an Academician.' 

Perchance my driver also was a gentle- 

25 



hock at the F * o n t 

man and a scholar. In the event, he 
sho :-ound coi n sense of his 

race. 'G :he night m t to the 

Continental.' Now the Hotel Continen- 
tal is Chicago at its best -et down on the 
corner of rue Rivoli and rue Castiglione. 
There I went, but it was awkward, for 
Dr. Carrel, the representative of the 
Rockefeller Institute, was to have met 
me at the Hotel des Saints Peres, and he 
being at Cornpiegne. in 'the zone.' no pri- 
vate telegram would be accepted and a 
letter would be delayed by the censor. 
In fact, it was several days before I saw 
him. 

Having settled my quarters. I went over 
the Seine to the 'left bank' to dine in the 
Latin Quarter. My dinner consisted of 
bouillon, a membre of chicken, haricots 
verts, Romaine salad, camembert, coffee, 
and a pint of Barsac — at a total cost of 
seven francs. 

It was the usual French scene of the 
rive gauche. A room crowded with small 

26 



Shock at the Front 

tables, at most of which sat bourgeois 
families. Here and there an officer, in 
most cases with ladies. At a table quite 
alone, a demure cocotte. Her eyes gleam 
at the sight of my French gold, which 
the war has made a rarity. 

In Paris, even the homely midday meal 
is touched with art. Once, at the lunch 
hour, I found myself in rue Cambon. An 
elaborate commissionnaire stood before 
a small restaurant. Curtains of some 
thin stuff guarded the rites within from 
the sacrilegious glance. I entered. The 
proprietor, with effusive dignity, bowed 
and shook my hand. I was in a room 
perhaps twenty feet square. There were 
six small tables and five elderly waiters. 
Several apoplectic old gentlemen, with 
the red ribbon of the Legion of Honor, 
were slowly gorging. From a raised dais, 
defended by a desk, two formidable old 
women surveyed the scene. When one 
of the old gentlemen had finished his pou- 
let roti, these secretaries recorded the fact 

27 



Shock at the Front 

upon their tablets, with frequent consult- 
ation, that no important detail might be 
omitted. Evidently I had unwittingly 
broken into a temple de gourmets. 

One of the attendant priests presented a 
paper on which were written a few hints 
as to the mysteries, without mention of 
the pecuniary consequences. 'What does 
Monsieur desire?' Monsieur desires a 
plain omelette. Consternation, with a 
camouflage of grief! Monsieur is encore 
jeune, yet so depraved? There is hot- 
house melon, thin soup, of an excellence, 
and old, but very old, wine. 

Monsieur will not relent. A long and 
ghastly pause, while the pariah sips from 
a glass of water, forgetful that in such 
places water is a symbol and not a bev- 
erage. At length the omelette arrives, 
assisted by three grieving men. It is 
shrunken and plaintive. It is furtively 
and hastily swallowed. The old women 
note the fact in their smallest hand. Five 
francs. Monsieur dies game, with a hand- 

28 



Shock at the Front 

some tip to Alphonse. Alphonse weeps 
for monsieur, and prays that light shall 
break on this misguided man. 

The day after this strategic defeat I 
went to the Ministry of War. It would 
be interesting to see whether a stranger 
could get permission to enter the Zone, 
that land of blood, bright with lightnings 
and vibrant with thunderous sound. 
There, the King's writ did not run. In 
the haste to kill — the sharp insistence 
upon murder — the casual foreigner had 
short shrift. No doubt mistakes were 
made. The innumerable saucisses, hang- 
ing like carrion-birds above the lines from 
Switzerland to the sea, sometimes looked 
down on innocent men blindfolded against 
a wall. The percentage of error was 
larger than in trial by jury. But then, 
under the circumstances, — the obvious 
necessity for haste, — even the innocent 
victims would readily excuse an occasional 
inaccuracy. The Ministry of War, with 
an infallible system of documents, were 

29 



Shock at the Front 

certain of this. Their files were clear. 
No victim had ever complained. Still, 
it would be well to have my papers in 
order. 

On entering the great portal of the 
building on Boulevard Saint-Germain, I 
was shown into a large waiting-room 
rilled with people. It was a cross-section 
of the French nation — a mixed but grave 
assembly. Upon the table were blanks 
on which one wrote his business. The 
statement was then given to a subaltern 
behind a wicket in the corner. From 
time to time, names were called and per- 
mits of entry were handed out. After 
waiting forty minutes, I received a 
printed slip directing me to the office of 
the Under Secretary of State. As there 
were no signs or other guides, I presently 
fetched up in a hospital ward. The at- 
tendants disentangled me, and I at length 
found the right corridor. A smart young 
attach6 comes out, debonair, polite, pro- 
fuse. Monsieur will no doubt get papers, 

30 



Shock at the Front 

but in three days. Desolated to keep me 
waiting. He will try to hurry them. 
He hopes that Monsieur will be patient. 

Three days pass, silent as the grave. I 
try the American Ambassador; surely he 
can help. The Embassy is well managed. 
In two minutes I am received by Mr. 

F , a secretary. In five minutes, I 

depart with a letter of recommendation 
from the ambassador to a high official in 
the Ministry of War. I go at once to his 
office. Nobody there. All at lunch from 
eleven-thirty till two. Promptly at two 
o'clock, I am again in the anteroom. My 
card and the ambassadorial letter are 
taken in. I wait one hour. Then I 
write on another card. It is swallowed 
up, like the first. But shortly there is a 

reply. Mr. L is not in. He has not 

been here this day; he will not return 
until to-morrow. Another day lost. 

On the following morning, while I sat 
in the court of the Hotel Continental, 
there entered with a quick nervous step 

31 



Shock at the Front 

a compact and energetic figure about the 
size of Napoleon. It was Carrel. In a few 
moments, we were standing by the fine 
military car in which he had come down 
from Compiegne. I was greatly struck 
by two soldiers who acted as chauffeur 
and orderly. Both were unusual. One 
of them was remarkable — tall, handsome, 
intelligent. 

'Where in the world, Carrel, did you get 
anything as beautiful as that?' I asked. 

'That man!' he replied, 'he is one of 
the first five comedians in France. ' 

And so he was. Then I remembered 
that men of every intellectual and social 
degree serve side by side in the French 
ranks. 

I go in this car once more to the office 

of Mr. L . Another courteous and 

charming young officer receives me. He 
regrets that his office cannot hurry the 
permit. They can act only on advices 
received from the Service de Sante, to 
which my application will have been re- 

32 



Shoe k a t t h c F r o n I 

ferred by the Secretary of State. He 
will telephone. He returns to say that 
the Service de Smite has never heard of my 
application. Very queer. Is Monsieur 
sure that he made one? Yes, quite sure. 
Then Monsieur had better go to the Bu- 
reau Piessac. 

After a prolonged search, I discover the 
Bureau Piessac in another wing. Now 
somewhat dazed, I seem to see a great 
functionary with a red beard, which in 
my disordered state looks like a crumpled 
ring of Saturn. This portentous organism 
is apparently of the variety known to 
naturalists as 'sessile,' that is, adhering 
by a broad base to its environment. I 
was afterwards to find this apparition a 
simple and pleasant gentleman, from 
whom I was to receive much friendly 
assistance. 

Carrel came in. I was presented to 
Monsieur M , who spoke English per- 
fectly and was kindness personified. To 
him I related my interview with the 

33 



Shock a t the Front 

courteous assistant of the Secretary of 
State. 

'Tiens!' said M . 'In France, when 

they are as polite as that, nothing is ever 
done. Do you think we could find the 
office of the polite young man?' 

I replied that we could try, though 
there had been no number or other dis- 
tinguishing mark upon the door. So we 
set out and after ten minutes of corridors, 

Monsieur M left me in a room in 

which four elderly scriveners were shep- 
herding large flocks of papers. They also 
were polite. It appeared that my young 
man might perhaps return in half an hour. 

I sat in a corner and listened to the 
rodent pens as they tried to gnaw through 
the net of red tape in which the official 
lion was enmeshed. 

Suddenly one of the ancient men said, 
'Are you not the Professor Tonson Por- 
taire?' 

'Yes,' I replied. 

'Tr&s bien! Here is something for you.' 

34 



Shock at the Front 

And he handed me a letter that had by 
chance turned up in the crowd on his 
desk. 'The Secretary of State presents 
his compliments and regrets infinitely that 
Grand General Headquarters, greatly to 
its disappointment, is unable to extend 
to Professor Porter the permission to go 
to Compiegne.' 

This letter I took to M , who said, 

'What did I tell you? When they are so 
polite as that, nothing is ever done. We 
must begin again. I will get you a carnet 
d'etranger, but it will take at least five 
days. It must go through two bureaux 
besides Grand General Headquarters.' 

The carnet d'etranger is the celebrated 
Red Book which enables the foreigner to 
enter the Zone. 

A delay of five days was sufficiently 
painful, but it would give time for French 
conversation. I could read French, of 
course, and I possessed a large vocabu- 
lary almost useless for everyday talk. It 
was years since I had lived with Mon- 

35 



Shock at the Front 

sieur and Madame Jacques on the Lake 
of Geneva. 

Monsieur Jacques was the pastor of 
Villeneuve and the official chaplain at the 
Castle of Chillon, then in use as a prison. 
Monsieur and Madame dwelt in a wide 
old house set in a large garden fronting 
the lake. Madame being childless, alas! 
had adopted seven cats. The ugliest, 
possibly distinguished by a graceful mind, 
was called La Fleur de la Famille. 

In the garden was a large tree which 
bore sickel pears, small, round, and sweet. 
Beneath its grateful shade we spread our 
frugal board. Two wires led overhead 
from a branch of the tree to the kitch- 
en window. Grace being said, Monsieur 
Jacques would call, 'Hola!' in his deep 
voice. There would be a rattle of dishes, 
and a little wooden car laden with cor- 
poreal cheer would slide down the wires 
to sustain the pastor and his guest. It 
was in late August. The declining sun, 
seeking his couch beyond the Jura, painted 

36 



Shock at the Front 

the lake with purple and gold. Warm 
odors rose from the flowers about us, and 
the sickel pears, dead ripe, fell in a slow 
and gentle rain. 

Those were far-off days. My memory 
held the virtues of the excellent Baucis 
and Philemon still undimmed, but their 
French was as the sound of a distant bell. 

In my present poverty I sought alms. 
I went to the efficient Director of the 
American Relief Clearing-House. 'Mr. 

B ,' I said, 'my French is feeble, to a 

degree. Behold me presently with French 
officers who have no English. The suc- 
cess of my mission rests on you. I must 
speak the language in five days. Find 
me a gifted and patriotic French family 
who will give up all their engagements for 
this period and cause this barren ground 
to bloom like the gardens of Babylon.' 

Mr. B was a real executive. He 

did not turn a hair. 'Come back to- 
morrow morning at nine o'clock,' he said. 

On the morrow, at the appointed hour, 

37 



Shock at the Front 

he produced the family, per specifications. 
I bear this public witness to their devo- 
tion. He told them that I was a great 
savant; a lie for which I shall always love 
him. I joined them every morning at ten 
o'clock and rarely left before midnight. 
Then, on reaching my bed, I fell into it 
more dead than alive. But I learned 
more French in five days than one would 
learn ordinarily in five months. 

My rapid progress was due in part to a 
simplification that I earnestly recommend 
to other ardent spirits. I made all the 
verbs regular and of the first conjugation, 
and I confined my remarks entirely to the 
historical present. The astonishing suc- 
cess of this procedure is another proof 
that the French are a gifted nation. 



CHAPTER IV 

At length Compiegne, historic, beauti- 
ful. I walked in the wonderful beechen 
forest. I stood upon the terrace of the 
Chateau, where Napoleon's Austrian bride 
had looked amazed along the entrancing 
vista cut in one night through miles of bil- 
lowing green by her all-powerful spouse. 
Compiegne fell to the Huns when the wave 
of invasion rolled over northern France. 
But they did not harm the place. It was 
the Kaiser's plan, it is believed, to receive 
on the celebrated terrace the submission 
of the dignitaries of France. Instead, one 
fateful day, during the battle of the Marne, 
there came over the wire words pregnant 
with the fate of civilization: ' Foch has 
pierced our centre. Fall back at once.' 

The Carrel Hospital — I'hopital tempo- 
raire 21 — was in what had been the princi- 

39 



Shock at the Front 

pal hotel of Compiegne, at the edge of the 
forest. The hospital was specialized for 
the study of infection. The worst cases 
from the trenches for miles around were 
collected there. Yet there was no infec- 
tion. In the morning, at the dressing hour, 
when the bandages were removed, and the 
ghastly wounds exposed, the eye was 
struck by the great display of stripped 
muscle, as fresh and wholesome as the 
meat in a shop. 

Some months later, I found myself in a 
large hospital in Amiens, where there lay 
in splints, in one room, more than fifty 
men with fractured thighs torn asunder 
by exploding shells. Not a man but was 
the color of dirty parchment, dull-eyed, 
listless, with foul tongue, and a low con- 
tinuous fever, the mark of a relentless sup- 
puration. At Compiegne every eye was 
bright, every cheek was clear, and the 
temperature charts were as level as the 
Elysian P'ields. Happy the patient who 
has no history! 

40 



Shock at the Front 

All this came from the application of ex- 
act measurements to the problem of sup- 
puration. Carrel, himself a scientist of a 
high order, had organized his hospital on 
an original idea. He began by attaching 
to his staff a great chemist and a mathe- 
matician. The chemist, Doctor Dakin, 
discovered that the hypochlorite of soda, 
prepared without free alkali and used in a 
special way found out by Carrel and his 
surgeons, had an almost miraculous effect 
on the foulest wound. The mathemati- 
cian, the Comte du Nouy, worked out the 
rate of cicatrization. He measured day 
by day the lessening surface of the wounds 
and plotted his measurements in the form 
of a mathematical curve. Such a curve 
serves for prediction. If, in a man of 
known age, the area of a wound is fifty 
square centimetres on the first day of the 
month, it will be ten square centimetres 
at a date which can be read on the curve. 
If the observed rate of healing does not 
follow the theoretical curve, it is because 

41 



Shock at the Front 

the nurse has failed to keep the Dakin 
solution in contact with all parts of the 
healing surface. 

I saw recently 1 in New York a man who 
had had for twenty-five years a large 
ulcer on the leg. He entered the War 
hospital of the Rockfeller Institute July 
first. His wound was measured and the 
theoretical curve was drawn. It was 
seen that the curve would strike the nor- 
mal at August 6. 'On August 6/ the man 
was told, 'You will be healed'; and on 
the promised day, the last square centi- 
metre closed. 

In Compiegne we lunched and dined — 
the Carrels, the surgeons, and the guests, 
for the hospital was a place of pilgrimage 
— in the garden of a villa commandeered 
for that purpose. There was good talk 
there, and a gayety protective against the 
strain of the wards. When any one 
cracked a joke, there was a moment's still- 
ness, then each of us grasped his knife and 

September 1917. 

42 



Shock at the Fran t 

in concert we gravely beat upon the table 
the refrain of a merry French song. 

We were never free from the sound of 
cannon. All day long and often half the 
night they thundered from the trenches 
six kilometres away. But Compiegne, un- 
scarred, slept in the milky sunshine, be- 
decked with flowers. There was a tennis- 
court, green-walled with flowering shrubs. 
We played each day at half-past four; 
light laughter and pleasant voices floated 
into the soft sky to meet the satanic over- 
tones of war. To a green bank at the side, 
men would crawl from their beds to watch 
the game. There they sat, a smiling, man- 
gled row. One day I found a pipe. It ap- 
peared that it belonged to a mass of ban- 
dages, a mere remnant of a man, armless, 
blind. We stop the game, we fill the pipe, 
light it, and place the stem in the groping 
mouth. The man laughs, his comrades 
laugh, everyone laughs — such fun! No 
man talks of his wounds — his pride and 
his secret grief. 

43 



Shock at the Front 

The surgeons at Compiegne had no- 
ticed that shock came on chiefly after 
wounds of the great bones, such as the 
thigh-bone, and after multiple wounds 
through the skin and subcutaneous fat, as 
from a shower of shell-fragments. These 
facts seemed very significant, although I 
little knew at the time that they would at 
length lead me to the discovery of the 
cause of shock. 

A question of urgent importance seemed 
to press for immediate reply: does the life 
in the trenches, under fire, predispose to 
shock? The bombardments in this war 
were of a new and strange intensity. It 
might be that certain men were sensitized 
by this highly abnormal environment. In 
that case a wound not historically grave 
might bring on shock. If the low blood- 
pressure and other symptoms of shock ap- 
peared immediately after the wound, a 
preexisting sensitization was probable. 
Remedies should then be employed before 
the wound was dressed. If, on the con- 

44 



Shock at the Front 

trary, there was a significant interval be- 
tween the wound and the onset of shock, 
sensitization was not the explanation, and 
shock must be the result of forces set free 
by the wound itself. On the length of this 
interval would depend the character of 
the treatment and the moment at which 
it could be most profitably applied. On 
the length of this interval rested the seri- 
ous practical question whether treatment 
must be given in the dressing-station or 
in the nearest field hospital. 

It was therefore my first duty to meas- 
ure the blood-pressure immediately after 
the wound. The wounded at Compiegne 
arrived too long after their injury. Be- 
sides, the hospital was too small. To 
solve my problem without undue loss of 
time, it was necessary for me to place my- 
self in a stream of wounded, for shock at- 
tacks only one or two men in every hun- 
dred casualties. I accordingly applied for 
permission to go to La Panne. 

Getting to La Panne was not so easy as 

45 



Shock at the Front 

it had seemed. The Bureau Piessac in the 
Ministry of War at Paris addressed the 
Belgian authorities. The famous head of 
the great hospital at La Panne, high in the 
favor of the King, made formal request 
that I should be appointed as physiologist 
to the hospital. The clumsy wheels of the 
administrative machine began protest- 
ingly to grind. Day after day went by, 
each day marked by deaths from shock, 
deaths possibly to be prevented by just 
such a research as we had planned, while 
the Belgian police, thick with dull suspi- 
cion, were goaded into action. The papers 
at length arrived. I went to the station to 
buy my ticket. The window was guarded 
by two gendarmes. 'A spy,' their fixed 
glare seemed to say. Science, humiliated, 
passed beneath the military yoke, and 
found a temporary refuge in the long and 
crowded train for Calais. 

As we approached the coast, the signs of 
war were multiplied. Immense camps 
stretched on either side: thousands and 

46 



Shock at the Front 

thousands of conical tents upon clean, 
sandy soil, faintly spotted with countless 
men in khaki. 

In Calais I stayed the night at a hotel 
called Grand. The next morning I was 
taken to see the hospitals. There was one 
youth of twenty-two whose right arm 
hung like a flail, quite healed, but useless. 
He had lost three inches of the humerus, 
the bone in the upper arm. If, at the 
first operation, the two separated ends 
had been joined by plates of steel, the 
limb would have been restored. 

'Don't you "plate" these cases?' I in- 
quired. 

'Oh, no,' replied the surgeon; 'we are 
afraid of suppuration.' 

'But the Carrel-Dakin method would 
prevent suppuration,' I ventured. 

'We do not use that here.' 

At four o'clock arrived the military car 
which was to take me to La Panne. Two 
friendly officers strapped my bags to the 
running-board. We waited at the railway 

47 



Shock at the Front 

station for a lady expected on the Paris 
train. A lonely English Tommy, bored 
almost to tears, gratefully returned my 
smile. He was a chauffeur of the Red 
Cross and had been on the job since the 
beginning of the war. His pent-up talk 
burst forth like oil from a tapped 'gusher.' 

'The Huns, sir, are careless-like about 
their little friends. When we took X, they 
left their pets shut up in the houses. I 
found two thirsty canaries, and Miss 
Coxe, — you know Miss Coxe, sir? she had 
two hens. Miss Coxe, she says to me, 
"We had better divide. Give me a cock 
and I'll give you a hen." So we did. 
They sing beautiful, those two cocks. The 
women chauffeurs drive too slow, sir. 
They let the auto bump on one side of the 
rut and then on the other. Of course I'm 
a male chauffeur, but it does seem to me 
it would be easier on the engine — and on 
the wounded — if they drove a little faster.' 

At this moment, Madame, the expected, 
emerged from the station, red in the face 

4 8 



Shock at the Front 

and as indignant as such a small lady 
could well be. She is Belgian. Her hus- 
band is an officer. Her permis was correct, 
but the station guards would not let her 
through. They wanted to take away her 
papers. Women are not allowed to visit 
their husbands, if it can be prevented. 
Naturally, a woman is furious when de- 
prived of her lawful prey. 

Finally, we are off. Our way lies 
through farms and villages. The fields are 
covered with standing crops ready for har- 
vest. We go through Gravelines, where 
we meet a convoy of fresh Boches, gath- 
ered in a few days ago. The road is a typi- 
cal Belgian highway, smooth, dusty, tree- 
lined. The trees on the west side are all 
bent by the ocean wind. The car is quiet 
and very fast. We fly across the great flat 
meadows. It is cool. Madame shivers, 
even under my blanket on top of her own. 
My military overcoat keeps me warm. 
Near Dunkirk, the dunes appear — white 
sand, green trees, low steep-pitched roofs 

49 



Shock at the Front 

of red tile. We stop for purchases in front 
of buildings wrecked by Zeppelins. Again 
the motor purrs. Again we wind the miles 
upon our reel. We reach the outskirts 
of La Panne. A last inquisition by the 
guards — the seventh since we started. 
Like all half-educated persons, they do not 
see the danger of generalizations. It is 
true that all men are liars. But it is not 
true that all the people lie all the time. 

I went to sleep in a room on the top 
floor of a villa directly fronting the North 
Sea. Several hundred mosquitoes shared 
the room with me. They did not sleep. 
They tasted a new flavor — exotic, but dis- 
tinctly pleasing. Presently, what physi- 
ologists call the summation of stimuli pro- 
duced its inevitable result. The threshold 
value was crossed and I awoke. I left the 
murdered Sleep upon her desecrated couch 
and watched the sea. 

A broad beach, furrowed by artillery 
wheels and pitted by the galloping cavalry. 
The busy waters, lighted by a phosphores- 

50 



Shock at the Front 

cent surf, strove to efface these marks of 
the struggle for existence, der Kampf um 
Dasein. Softly they murmured at their 
priest-like task. The mooring posts, far 
out, were black against the wave. Black 
fishing-boats slept on the beach, like cat- 
tle in a field. A moon, largely decayed, 
touched with silver gleams the bayonets of 
the patrol. Three lines of barbed wire 
snarled along the tide-mark. 



CHAPTER V 

La Panne is the extreme left of the Al- 
lied line. It is the seat of a hospital of 
eight hundred beds, ably directed by the 
celebrated surgeon, Doctor de Page. I 
was stationed in the salle de reception, the 
receiving ward to which the ambulances 
bring their loads directly from the firing- 
line. 

There comes a rumble on the stone- 
paved street, an ambulance drives up, 
the word blesse passes down the corridor, 
and the brancardiers appear with the 
long staves. A group of dark forms 
gathers about the motor-car in the star- 
light, the curtain is unbuttoned, the 
loaded ambulance stretcher is pulled out, 
an empty exchange stretcher is shoved 
in, and the ambulance departs for the 
trenches. 

52 



Shock at the Front 



The mass of dirty cloth and bloody 
bandages is carried into the ward. A 
surgeon comes, rubbing his eyes. The 
wounded man is radiographed. This 
done, the radiographer places his hand 
over the supposed site of the fragment. 
A great magnet is let down upon the 
hand. If the embedded steel is not more 
than seven centimetres deep, the metal 
object is shaken by the magnetic waves 
and its vibration can be felt. The radiog- 
rapher writes for the surgeons a report, 
giving the location and depth of the frag- 
ment. 

Meanwhile a nurse shakes my bed, 
where I lie fully dressed, sound asleep, 
tired with fourteen days and nights of 
continuous service. I open sleepy eyes. 
1 A bad blesse. You are asked to take the 
pressure.' 

I find the patient in the operating 
theatre. An intense light floods the trim 
surgical nurses, the bloodstained band- 
ages, the patient half-naked on the table, 

53 



Shock at the Front 

— the leg and foot so oddly at variance 
with the broken thigh, — the three sur- 
geons, in white, their shoes in white sterile 
wrappers. They wait silently while I put 
the hollow cuff on the upper arm and the 
ausculting tambour at the fold of the el- 
bow. The air is pumped into the cuff; 
the artery is stopped; I slowly diminish 
the air-pressure; a faint sound in the 
stethoscope, like a far-off cry for help. 
I read the gauge — 140 millimetres, the 
maximum blood-pressure. The air es- 
capes again; slowly the recording needle 
passes along the dial; the sound of rush- 
ing blood increases for the moment; as 
the artery takes its full size, the sound 
fades away — 92 millimetres, the minimum 
blood-pressure. The normal is 97 ; there 
is no shock yet. 

The patient is turned and a hollow 
needle is passed into the vertebral canal. 
Cerebro-spinal fluid is sucked into a 
syringe containing the anaesthetic novo- 
caine; and slowly the mixture is driven 

54 



Shock at the Front 

back into the canal. The tourniquet 
above the wound is tight; but little 
blood escapes from the torn vessels. The 
wound is opened freely. Bruised flesh, 
fragments of dirt, pieces of cloth, and 
splinters of bone are scraped out. The 
bleeding points are ligated. The Carrel 
tubes are placed for the Dakin solution. 

I am at the pulse. Suddenly it fails. 
He is pulseless. His abdominal arteries 
have dilated. Through the open gates 
the arterial blood is rushing into the veins. 
The man is bleeding to death in his own 
veins. He becomes deathly pale; the 
whites of the eyes show; he is scarcely 
conscious. The nurse hurries the band- 
age about the padded splint. He is 
borne to his bed, wrapped in blankets, 
surrounded with hot bottles. The foot 
of the bed is placed on two chairs, so that 
the blood may drain by gravity from the 
congested abdominal veins back to the 
heart. The vein at the elbow is pre- 
pared. He gets a few drops of adrenalin 

55 



Shock at the Front 

solution: the pulse comes back, color 
floods the face; the eyes become natural, 
they open; he speaks — he is saved. 

But no — he is pale again, he vomits, 
the pulse is irregular. The adrenalin is 
attacking the heart. Will he die? Shall 
we have failed him? I pray silently. 
The ward is hushed. Two, three minutes 
pass, dragging like hours. The pulse 
strengthens. The heart is again regular. 
Youth has its day. He lives. Now, to 
make sure. Warm serum 1 is passed into 
a vein. The blood-pressure rises. The 
arm is bound up. The electric reflector 
is brought by two men, and placed astride 
the bed, covered with blankets. Miss 

T , a Scotch angel of uncertain age 

and unfailing devotion, stands by. I 
wait at the wrist. A single shaded light 
burns in the great ward; the screens 
round my bed rise ghostly in the gloom. 

1 A solution of common salt and some other sub- 
stances in the proportion in which they normally 
occur in the blood. 

56 



Shock at the Front 

We watch, while beat by beat the ebbing 
flood returns. The clammy hands and 
feet feel again the warm and healing 
tide. He lies like a cocoon in his warm 
blankets. His face is calm. He has 
cheated the grave. He tells us of his two 
children. The mother is dead; the waifs 
are in an orphan home; one is eight years 
old, the other six; he has not seen them 
for two years — not since the war began. 

Trembling, I go out on the beach and 
watch the sea — that northern sea which 
has looked un vexed on so many foolish 
wars. The tide is low. The wide sands 
are smooth and firm. Two officers are out 
for a morning gallop. In the distance 
a battery is drilling. The horses are of 
heroic size in the early mists. I hear the 
faint thud of hoofs on the hard beach. 
Above, a solitary aeroplane swoops low, 
while the observer searches the depths 
for a lurking submarine. 

So the days and the dreadful nights 
went by, with their unceasing stream of 

57 



Shock at the Front 

broken men. Often I lay sleepless through 
the dark hours, while next me howled a 
blesse mad with subconscious agony and 
the last wild ether dream. But there 
were compensations. One gave and gave 
and gave — a blessed thought. 

And there were spectacles of poignant 
interest. Late one afternoon a nurse 
came running to tell me that there was 
an English monitor off the beach. We 
hurried out, full of the charitable hope 
that she would shell Ostend. The sun 
was setting. A golden light touched 
soothingly a half-tamed sea, still sulkily 
mumbling. A ship of no great size lay a 
mile from shore, circled by two torpedo- 
boats. They kept untiringly a ceaseless 
round. We strained our eyes. Suddenly 
there burst from her side a flame as 
big as a house, followed by an immense 
cloud of black smoke. We held our 
breath. In a few seconds there was a 
sound that was more than a sound. It was 
a commotion in all that part of Belgium. 

58 



Shock at the Front 

And then, a moment later, a faint boom, 
fifteen miles away, where twelve hundred 
pounds of trinitrotoluol wrought ruin in 
Ostend, the resort of tourists. 

Presently there was another dim sound, 
like the low curse of a malevolent fairy, — 

Strange terrors seize thee 
And pangs unfelt before, — 

and down from the sky fell a great shell. 
A huge column of broken water towered 
above the waves, and all was once more 
peace. 

The spotless nurses walked upon the 
beach, and we heard the maids laying the 
table for our evening meal. Again the 
monitor shook heaven and earth, and 
again there came the great reply, more 
threatening than before. 

It was enough. A German plane hov- 
ered far in the blue and guided with a 
gesture these mighty thunderbolts. The 
monitor ceased firing, turned her prow, 
and made for England, still circled by her 
tireless guard. 

59 



Shock at the Front 

The receiving ward was staffed with 
four day and three night nurses. They 
were socially of the class called ladies. 
The two chiefs, one for the day and one for 
the night, were professionals; the others 
had volunteered for the war. As I was 
on duty continuously for more than a 
fortnight, I became well acquainted with 
them all, especially the four who served 
by day. One of these was a very intel- 
ligent Scotchwoman who had studied at 
the University of London. A second was 
a shy comely creature from the north of 
Ireland, with the loveliest red-gold hair 
ever seen. The third assistant looked 
as if she had just stepped out of a Delft 
plaque. She was a rosy young Belgian, 
daughter to a successful physician in 
Ghent. This girl spoke four languages with 
almost faultless ease. Scrupulously neat, 
her pride was in her immaculate hands. 
Often, on mere suspicion, as it seemed to 
my coarser perceptions, she would say: 
' It is time for me to wash my pows.' 

60 



Shock at the Front 

One morning, I found Miss B , the 

chief of the day squad, very sad. Weep- 
ing, she told me that it was the anni- 
versary of her brother's death, — shot 
through the abdomen, — a gallant youth. 
The afternoon of our sad talk, there came 
to us another youth, of her brother's age, 
mortally wounded. When she undid the 
emergency dressing, the intestines were 
found outside the body. He died within 
an hour. Screens were placed about his 
bed and I heard the four nurses in earnest 
conversation. I came nearer. 'We can- 
not send him to his grave like this. ' It 

was Miss B 's voice, rich with unshed 

tears. They brought me needles and 
forceps. After a hard struggle, the pro- 
truding bowel, swollen with post-mortem 
gases, was put within, and the gaping 
wound sewed up. Nobly, gratefully, the 
stricken woman dressed the poor clay for 
the last sleep. After a long, long year 
her chance had come, to lay vicariously 
her hero in the tomb. 

61 



Shock at the Front 

One of the assistant night nurses used 
to say ' But, sister, ' in a tone exactly like 
the bleating 'ma-aster' of Pascalon in 
Tartarin de Tarascon. Doubtless, a bad 
accent is sometimes mortal, and at first 
this good soul markedly lowered my 
vitality. The more so that for a time she 
thought me cruel. It is extremely im- 
portant in shock that the patient should 
rest in the inclined position, with the body 
higher than the head. When this kindly 
but uninstructed girl would approach 
with the three fatal pillows, I would shoo 
her away. Finally, she helped me ease a 
soldier with a broken leg. Quite without 
cause, she was suddenly converted. 'You 
are so gentle, ' she said. Her heart being 
gained, what she would have termed her 
reason was open to attack. She con- 
sented to listen to the indictment of the 
three pillows. The human understand- 
ing behaves exactly like the oyster. Al- 
most immovably attached to the rock of 
prejudice, its shell is firmly closed at the 

62 



Shock at the Front 

approach of a new idea, — strange, and 
therefore suspicious, — possibly foreign. 

Last night, August 30, 191 6, was my 
first quiet night since I began to sleep 
with the wounded, more than two weeks 
ago. I slept from 1 1 p.m. to 6 a.m. and 
am much refreshed. The night before 
was really terrible. A man shot through 
both lungs, half-crazed, shouting and 
groaning, with bubbling sounds inexpres- 
sibly ghastly. I can sleep now in the 
strangest turmoil, but this was too much. 
I went for a walk, but it was a mistake. 
When I came back, a breathless nurse told 
me that she had looked everywhere for 
me — there was a fresh blesse, very bad — 
please hurry. It was Sergeant Edouard 

G , about twenty years old, — the thigh 

crushed by a shell. 

This morning I have been engaged in 
two cognate pursuits, visiting the police 
and hunting the 'chamois.' A plague 
on both their houses! The Belgian po- 
lice are — But I will tell this another time, 

63 



Shock at the Front 

if holding in is not fatal. As for the 
chamois, the pleasant land of counter- 
pane, in the receiving ward, is naturally 
thick with them. Myself, I am not skill- 
ful at catching them. When they are 
very full, I can sometimes seize one by the 
horns, but usually they escape, leaving 
an equator of low eminences. This dif- 
fers from the other equator in two re- 
spects: first, it is not an imaginary line; 
second, I do not speak disrespectfully of 
it. 

The most affecting spot in La Panne 
was the room where the maimed were 
fitted with artificial legs. Any morning, 
one might find sitting there several men, 
who waited patiently their turn, with their 
naked stumps sticking straight out before 
them. A little English boy, nineteen 
years old, but looking scarcely fourteen so 
worn and frail was he, had lost his leg 
above the knee by a shell that had struck 
in the heavy artillery post. 'You know, 
sir, I wasn't looking for anything like 

6 4 



Shock at the Front 

this. ' Inconsequent human nature! How 
should a little English boy divert the in- 
exorable course of the great law of cause 
and effect ! 

The outcome of the work at La Panne 
was an organization for the systematic 
treatment of shock, employing all the 
remedies then known, basing them on re- 
peated measurements of the minimum 
blood-pressure. These special measures 
saved two thirds of the cases, but the 
questions with which I had come to La 
Panne were still unanswered. The dif- 
ficulty was again the interval between the 
wound and the arrival in the hospital. It 
was obviously necessary to be actually on 
the firing-line. Doctor de Page accord- 
ingly arranged that I should meet General 

P , then colonel commanding the 58th 

French brigade, in the sector which in- 
cluded Nieuport. 

This distinguished officer was a vete- 
ran of the Moroccan campaigns. He was 
brave, gay, and highly intelligent. Like 

65 



Shock at the Front 

so many of the French, he had an appreci- 
ation of physiological science unusual in 
less favored nations. Claude Bernard 
had not lived in vain. 



CHAPTER VI 

One happy day the general arrived in 
his gray limousine and took me to brig- 
ade headquarters. It was in a villa which 
had belonged to a Belgian of some taste. 
There was a large living-room, some good 
prints on the walls, and at one end a 
billiard-table, now used for military maps. 
At the other end was the table at which 
we dined. By this time our friendship 
had made great strides. The general was 
enchanted to find that I smoked a pipe. 
Himself, he adored la pipe. His tobacco 
left something to be desired : it was a spe- 
cies of Algerian hay. I gave him of my 
choice Virginia leaf. We were brothers. 
He would visit me in Boston when the 
war was over. 

The dinner was superlatively good. I 
asked him how he managed. 'Oh,' he 

67 



Shock at the Front 

replied, 'my chef before the war was the 
chef of a great New York hotel. But this 
is easy,' he continued; 'you should have 
seen him at Verdun. Eight of us and the 
chef in a hole thirty feet under ground. 
He had for his art a space only two feet 
square,' — and the general marked such a 
space on the tablecloth, — 'but we lived 
just the same.' 

He led me to the maps. ' You will like 
to see what we are doing to-day. Observe 
this salient. We make a curtain of fire 
behind it, so that the Boches can neither 
get in nor get out. Then our shells destroy 
their defenses. Every hour an aeroplane 
makes a photograph. Here are the photo- 
graphs. You see they are quite large and 
very clear. Even the posts of the barbed 
wire show. We do not send our men for- 
ward until we see that all the wire is 
down.' 

A dozen steel helmets were brought. 
The general and his staff helped me to 
find one that would fit. Then we set out 

68 



Shock at the Front 

for Nieuport. There I was consigned to 

Colonel D , of the 3d French Line, 

another veteran of the Moroccan wars. 
Eight delightful days I lived with this 
dear man beneath the shells. 

Nieuport lies upon the Yser, the tidal 
stream that stopped the German rush for 
Calais. That June before the world went 
mad, the peaceful town drowsed in the 
sun — the pearly Belgian sun that painters 
love. The men went down to the sea in 
their fishing boats, or worked their fields; 
old women, their lace upon their knees, 
sat in a patch of shade before the door and 
plied their bobbins; children, with shrill 
sweet voices, darted about like birds; the 
creaking wain went to and fro piled high 
with harvest. Four thousand simple folk! 
Not one remains. Their houses too are 
gone. Their ancient church, their historic 
tower, are mounds of ruin. And still the 
hissing shells, hour by hour, day by day, 
tear down the crumbling walls, adding 
fresh ruin to a scene most desolate. The 

69 



Shock at the Front 

people of the sun are gone. Another race 
inhabits there. They live in holes be- 
neath the ground. They come not forth 
except to kill. 

I too lived in a hole beneath the ground. 
I came not forth except to save. At least 
that would have been the wiser part, but 
the life was so interesting that in truth I 
roamed about like a boy at the fair. By 
day the soldiers lay perdu. The streets 
were empty. It was incredible that the 
blast of a trumpet would raise two thou- 
sand men. With the night they swarmed. 
The place was full of horses and carts, 
bearing water-casks, sand-bags, gabions, 
beams, chloride of lime, barbed wire, am- 
munition — a hundred articles needed in 
the trenches. There was no light except 
the moon. Strange shadows crept along 
the roads. 

One morning I walked with Lieutenant 

N . 'Suppose we ask Captain B 

to show us a seventy-five,' he said. 

We found Captain B in a dugout 

70 



Shock at the Front 

lined with beautiful maps. He led us to 
a passage that dipped beneath the ruins. 
It was perhaps twenty-five feet long and 
eight feet wide. At the lower end was the 
celebrated soixante-quinze, poking its shin- 
ing nose out of a hole in the wall. I sat in 
the gunner's seat and trained the cross 
wires on a distant object, opened and 
closed the breech, and examined the re- 
coil. 

My pleasure was so evident that kind 

Captain B was touched. ' Perhaps 

you would like to see some practice on the 
Bodies?' 

'I most certainly should,' I answered, 
much gratified. 

So the gun crew took their positions, we 
stuffed our ears with wads of cotton, and 

Captain B went to his post, a short 

distance away. There he called up an 
observation tower. The observing officer 
gave him the number of a square in the 
German lines, where a few shells might 
have a salutary effect. The captain called 

71 



Shock at the Front 

to us the number and the range, 4350 
metres. A soldier opened a cupboard in 
the wall, seized one of the shining brass 
shells, placed it nose down in a fuse-ad- 
juster, and turned a handle round a grad- 
uated scale until he reached 4350. By 
this operation, the fuse was set to explode 
the shell at the given range. In an instant 
the shell was in the piece, the breech-block 
swung shut, there was an ear-splitting 
crash, and away flew our compliments to 
the Boches. The barrel slid swiftly back, 
spat out the shell-case at our feet, and 
returned to its position, passing on the 
way over a cushion of grease. The ob- 
server telephoned the result, the range 
was corrected slightly, and off went an- 
other shell. After twelve shots were fired, 

Captain B returned with a pleasant 

smile to receive our thanks for his cour- 
tesy. 

This battery was so skillfully masked 
that I never saw it again, though it was 
not more than three hundred yards from 

72 



Shock at the Front 

the cellar where I lived. No wonder the 
Huns could not find it. There was a 
ruined garden, with pear trees, in front of 
my quarters. I used to read in the garden 
while the enemy tried to silence these guns. 
Five or six times a minute the familiar 
curving hiss would rush toward the sus- 
pected spot; there would be a loud explo- 
sion and a cloud of black smoke. But the 
seventy-fives were never struck. Some- 
times the great shells from our heavy ar- 
tillery would pass high above me, seeking 
some distant objective. They gave a new 
flavor to Daudet. Imagine: three pear 
trees and an optimist — above, filling all 
the upper air, the vast soft weary groan- 
ing of an eleven-inch shell. This was not 
bravado — far from it. To stay all day in 
a damp black cellar was insupportable; 
outside, one place was as safe as another. 
In fine weather we ate our meals — the 
colonel, three officers, and myself — in one 
corner of a half-destroyed court. Punc- 
tually to the minute, brushed and combed, 

73 



Shock at the Front 

we arrived at the small round table. 
Through the centre of the table rose the 
trunk of a tree, the branches of which 
were trimmed flat about ten feet from the 
ground, to make a canopy. We sat our- 
selves gravely down. The good colonel 
would fumble in the pocket of his tunic 
until he fetched out his great horn specta- 
cles. He would place them carefully upon 
his martial nose. Then he would pro- 
claim, l Ordre,' in a deep, serious voice, 
and reaching forward would take up a 
glass holder containing the menu. This 
he would read to us slowly, from hors 
d'ceuvres down through cheese and coffee. 
It was a way of giving thanks for the food 
that was set before us. After this cere- 
mony, he would nod to the orderly, whose 
white coat and brass buttons illuminated 
the middle distance. The hors d'ceuvres 
would advance. It was the signal for con- 
versation. 

Meanwhile, the shells went over, singly 
or in flocks. I sat on the colonel's right, 

74 



S h o c k at the Front 

about eighteen inches from him. He had 
two voices — one for giving commands to 
his twenty-five hundred men, the other 
for ordinary talk. He always addressed 
me, as a foreigner, in the tone in which he 
commanded the regiment. The dinner 
proceeded sedately through seven excel- 
lent courses, undisturbed by the artillery. 

During my stay at Nieuport two shells 
fell in that court; one slightly wounded 
our valuable pump, the other just missed 
our treasure of a cook. The stove was at 
the other end of the court, in a recess. 
The shell exploded outside this retreat. 
In that neighborhood not a square foot 
but got its piece of steel. The hurtling 
storm swept by the culinary shrine. For- 
tunately, the chef was at the stove, his 
post of duty; his deserts were great and 
he escaped unharmed. 

On stormy days we dined in the colonel's 
cave. It was a tight fit. Through an open 
door we saw our commander's bed, along- 
side a stove in which the fire never was 

75 



Shock at the Front 

allowed to go out. Even with this, the 
walls were always damp. 

One evening the soup had just been 
served when the telephone rang. Lieu- 
tenant C , who was acting adjutant 

that day, saluted the colonel and reported 
that a party of Boches were cutting grass 
behind their third line. 

'Tell Captain F ,' said the colonel, 

between two spoonfuls. 

Captain F was of the artillery. 

Before the soup was taken away, we heard 
the seventy-fives at work on the Boches. 
This speed and accuracy were due to the 
ever-watchful observers. I loved to go to 
the observation towers, especially at night. 
They were usually at the top of some 
ruined building. One stumbled up two or 
three ladders and at length entered a little 
wooden cage which held two men, elabo- 
rate telephones, and several powerful tele- 
scopes. With these you could have seen 
the buttons on a man's waistcoat miles 
away. The enemy was, however, rarely 

76 



S h o c k at the Front 

visible; he stuck closely to his communi- 
cation trenches. When darkness fell, the 
flares began. The French flare had a 
parachute, and for several minutes lighted 
up hundreds of yards as bright as day. 
As far as the eye could see, up and down 
the lines, these witchfires burned. 

The aeroplanes liked to fly near sunset, 
when the air was quiet. Then we would 
hear our pompoms, fifteen staccato barks, 
and a pause. I would rush up the cellar- 
steps and search the sky. There, a mile 
aloft, would be a German plane. Off 
would go a pompom, fifteen rounds. A 
moment later, fifteen soft white fleecy 
little clouds of shrapnel, like puffs of 
thistle-down, would break out one after 
the other, about the flying plane. The 
planes were often hit, but seldom in a 
vital place. 

The officers' caves were alike in one 
respect : they all contained mirrors in im- 
mense gilt frames. These mirrors had 
been found in the deserted houses. The 

77 



Shock at the Front 

major's cave was rather a show place. It 
consisted of two tiny rooms, dressed with 
flowers, and very neatly kept. On a table 
in the 'salon' was a marble bust, a derelict. 

'You must not miss my garden,' said 
the major, swelling with pride. 

I looked for the garden; it was not in 
the room. 

'No,' said my friend, with an indulgent 
smile at my little irony, ' it is not in here. 
It is outside. You can see it through the 
window.' 

Now, the window was a cellar-window 
and opened into a little 'area,' where for 
the light the earth had been dug away in 
a space twenty-four inches by twelve. 
Here, indeed, was the garden. 

'Of course,' continued the major, 'with 
the ground at my disposal, you would 
not expect me to go in for shrubs. I have 
had to content myself with a lawn.' 

A perfect lawn it was — not a weed — a 
battalion of tiny bright green grass-blades ; 
very refreshing. 

78 



Shock at the Front 

I went into the trenches to measure the 
blood-pressure. The trenches lay on the 
other side of the Yser. We crossed a pon- 
toon bridge. Spare pontoons were an- 
chored in the river, in case the bridge 
should be struck by a shell. We entered 
a communication trench. Here and there 
were signs, where men had been killed 
often enough to show that a German 
sniper had marked that particular spot: 
'Obligatory'; 'Forbidden'; 'In view of the 
enemy'; 'To grand redan.' 

Our trench is narrow and it is deep 
enough to protect the head. It winds 
through fields covered with grass and pop- 
pies. These overhang the edge and brush 
our faces. The bottom of the trench is 
covered with a slatted walk about eighteen 
inches wide. We meet great pots of hot 
food, borne on a pole hung between two 
men. Happily, we are not fat; we slide 
by without being burned. 

Soon we are in the lines. Here are real 
defensive works, heavily timbered, and 

79 



Shock at the Front 

•with space for many men. At frequent 
intervals are the burrows in which the 
men live. Telephone wires run near the 
bottom of the trench, on the side next the 
enemy ; they are fastened to the earth with 
long wire staples. From time to time we 
peep through an observation-hole, but we 
do not stand more than two minutes in 
any one spot ; always there are aeroplanes 
and tower observers on watch, and we 
may get a shell. The shells are now flying 
over us, with a noise like the tearing of a 
great sheet. Presently, we reach the point 
nearest the enemy. It is near indeed; 
about the length of a tennis-court. I 
look through a periscope and there, as 
clear as in a clean looking-glass, are long 
mounds of earth and sand-bags — the 
German 'trenches,' one hundred and 
fifteen feet away. Apparently deserted, 
absolutely silent, they lie heavily upon 
the unkempt fields, mile upon mile. 
Their sinister quiet speaks louder than 
the screaming shells. 

80 



5 h o c k at the Front 

The poilus are delighted with the blood- 
pressure apparatus. It is like a game. 
Their faces are wreathed with smiles. 
They take off their tunics, roll up their 
sleeves, and are proud to be told they are 
1 normal.' We keep our voices low and hug 
the front wall of the trench, but other- 
wise we might as well be in the Boulevard 
des Italiens, although, now I think of it, 
that also is a dangerous place. We are 
about to return, when the surgeon is tele- 
phoned that an officer is wounded. Bicy- 
cles are ordered to meet us at the third 
line, and we run back. The surgeon is 
younger, but he is a trifle too plump. I 
keep him in sight. As we approach the 
machines, he calls over his shoulder, ' Can 
you ride a bicycle?' 'Perfectly,' I reply. 
I do not say that it is thirty years since 
my last ride. We mount, and he hurries 
off without looking behind. I follow. It 
is a wild ride. The roads are filled with 
debris — low heaps of brick and plaster 
from the tumbling walls. When I go over 

8i 



Shock at the Front 

a heap, my helmet flies into the air; it 
requires nice calculation to be under it 
when it comes down. Clerk Maxwell 
is right: science is indeed a matter of 
grammes, centimetres, and seconds. 

I had now based the treatment for shock 
on exact measurements of the blood-pres- 
sure, and I had determined that the habit- 
ual bombardment does not predispose. 
There remained the study of the blood- 
pressure in the fury of an assault, the 
question of the cause of shock, and the 
hope of a new remedy. Nieuport was 
exhausted. The war at Nieuport was all 
in the day's work. After two years, the 
daily round was the daily round, and it 
was nothing more. My comrades told me 
that, when they were at Verdun, there had 
sometimes been emotions, if their memo- 
ries were not at fault. So I went to 
Verdun, that 'name of thunder.' 



CHAPTER VII 

On the stroke of twelve, October 13, 
1916, I arrived at Bar-le-Duc, the base for 
Verdun. A chill rain monotonously fell 
upon slimy streets, innocent of cabs. I 
hired a small boy to pilot me a mile through 
the mud to the Lycee where Surgeon-Gen- 
eral W had his headquarters. My 

little guide was cold, wet, and hungry, 
but his depression vanished when I ad- 
dressed him as 'Sir,' and asked his opinion 
of the war. To General W I pre- 
sented a letter from Dr. Turner, consulting 
surgeon to that Army, praying that I be 
given every aid. 

'But your pass is only to Bar-le-Duc, 
sixty kilometres from the front!' — 

'Please, then, telephone to General 
Joffre's headquarters and ask for full 
powers.' 

83 



Shock at the Front 

After a gasp or two, the suggestion was 
accepted. General W went to con- 
sult the general commanding at Bar-le- 
Duc. In half an hour, he told me that 
the chief surgeon at Grand Headquarters 
knew of the research and that there was 
hope of a pass. ' Come back to-morrow 
morning at nine o'clock.' 

I departed for one of the loneliest days 
and nights I have ever spent. The two 
dens of chief repute in the town were 
filled. I put up in a room beyond words. 
Too ill to eat my dinner, I went to bed at 
seven and shivered there until seven the 
next morning. At nine o'clock I reported, 
and to my surprise received a letter in- 
structing officers of the Second Army to 
give me all possible assistance. At once 
I asked for a car. I got a magnificent 
high-powered Sedan. My first care was 
to be driven in state to the wretched hostel 
where I had spent the night. My hope 
was that all this splendor would teach 
them a lesson. Perhaps next time they 

84 



Shock at the Front 

would not ask an American officer to 
bathe in a single pint of dirty warm water. 

Soon I was flying along the great road 
that leads to the front from Bar-le-Duc. 
I was bound for the Mort Homme. 
Along this road passed the greatest trans- 
port the world had ever seen. Gangs of 
German prisoners toiled constantly to 
keep the road in repair. For more than 
thirty miles there was at the side a con- 
tinuous ridge of broken stone. The work- 
ing gangs drew steadily from these stores 
of road-metal and the losses were as 
steadily supplied. It was a task for Sisy- 
phus, the son of /Eolus. On this work 
hung the destiny of France. 

The valley through which we ran is very 
beautiful — hills everywhere, brooks, green 
meadows, and cultivated fields. 

We stopped some miles on this side of 
the Mort Homme; the road beyond was 
under fire, and by day it was too danger- 
ous. I was given dinner in a kitchen 
with several agreeable officers. As soon 

85 



Shock at the Front 

as it was dark enough to make the road 
safe, we left for Chateau Esne. After an 
hour or more, in the dark, without lights, 
in the rain, muddy beyond belief, we halt- 
ed in a ruined village, and transferred to 
the black depths of a big ambulance. On 
we went, bumping over shell-holes. 

The Chateau Esne is a poste de secours, 
at the third line of trenches, in a cellar 
of what once had been a glorified grange. 
It was a miserable hole, where one could 
stand upright only in the centre. The 
cold mists of late October drove through 
it, pursued by an eager, nipping wind. 
My poilu, a tall bearded man plastered 
with clay, showed me a sort of kennel set 
off with rough boards picked up in the 
fields. He brought a sack stuffed with 
straw for me to lie on. It was dark choc- 
olate color. He surveyed it doubtfully. 
The honor of France demanded some- 
thing more. He went to the case con- 
taining surgical dressings and cut off 
pieces of aseptic gauze, which he laid upon 

86 



Shock at the Front 

the sack, overlapping them like shingles 
on a roof. 

I lay down, but not to sleep. At mid- 
night I was routed out to see a man who 
had been shot through the head. The bul- 
let had drilled a neat hole through the back 
of his steel helmet and through his skull. 

When day broke, a cold rain was falling. 
I looked out on the tragic slopes of Dead 
Man Hill. Craters and graves — graves 
and craters — in horrible confusion! Dur- 
ing the Great Drive, twenty-five thousand 
wounded men had passed through the 
Chateau Esne, that wet dirty verminous 
hole. They often lay in rows outside, 
among the graves, waiting their turn. 

But at the moment there was no great 
battle here, and I went to the Somme, still 
searching for emotions. 

My way led through the base at Amiens. 
The Hotel du Rhin was filled with Eng- 
lish and French officers. I was placed at 
lunch with an English captain, returning 
from a furlough. We talked, of course. 

87 



Shock at the Front 

He made me a map on the back of the 
menu, so that I should be sure to find a 
small oyster-house that he liked. Yester- 
day he had bought two hundred oysters, 
as a present to the mess. Since then news 
had come that on that day the regiment 
had gone 'over the top,' and all the offi- 
cers but four had been killed. He said 
that he was doing himself well, because he 
did not expect to last long; this, by way of 
apology for the Chateaubriand steak he 
was eating. The Epicurean philosophy 
fits well in this Roman war. 

It appears that the Germans are at their 
old game, pushing hard at the liaison of 
the French and English lines — naturally 
a weak spot. 

I supped with Turner, who had just 
come from Foch. The great strategist 
had said that his chief trouble was not the 
Boches — they were relatively easy; his 
chief anxiety was to find water every day 
for two hundred thousand horses and four 
hundred thousand men. 

88 



Shock at the Front 

The next day Tuffier took me to the 

village of S . There I was in a rough 

field hospital of twenty-five hundred beds. 
They had had twenty-seven hundred fresh 
cases in a single day. The courteous 
medecin-chef directed an officer to show 
me to my 'chamber.' I followed the of- 
ficer. He led me to a low wooden build- 
ing, somewhat worse than the rest. 
Within were two rows of tiny cubicles, 
with partitions of unplaned boards, and a 
blanket that served for front wall and door 
combined. Here the staff slept. Between 
the rows of cubicles ran a dark passage 
two feet wide. We reached my chamber. 

'Be a little careful,' the officer re- 
marked. ' Don't step in that hole in 
front of your door. The Boches were here 
last night. They dropped a bomb in 
there and it hasn't yet gone off.' 

It was interesting. The French had 
sent a squadron to bomb a railway junc- 
tion in Germany. The night was not 
very clear, and in the excitement an un- 

89 



Shock at the Front 

lucky bomb had fallen on a hospital. In 
revenge the Germans had dropped twelve 
bombs on the hospital at S . For- 
tunately, nine fell in the open, and two 
did not explode. Mine was one of these. 
The twelfth bomb burst in a crowded 
building, with very serious results. 

Again I was disappointed. The same 
old mill of death ground steadily, but 
there was no great offensive. Winter was 
at hand, and I perforce took ship for home. 
It was the Espagne. Worn out, I went to 
bed at eight o'clock the first night out, 
although we were still in the submarine 
zone. At once I fell sound asleep. At 
ten minutes past eleven, I was roused by a 
voice shouting down the corridor, ' Every 
one on deck — the ship is sinking.' 

I sprang from my bunk. Around me 
all was silence. The others had already 
gone. I reflected that no great ship ever 
sank in less than twenty minutes. I 
could dress in ten. It was a cold Novem- 
ber night. In an open boat I should per- 

90 



Shock at the Front 

ish without warm clothes. So I put on my 
uniform and my thick military overcoat, 
seized my life-belt, and rushed out. In the 
corridor I ran against a bolted steel door. 
Fortunately the bolts were on my side. I 
hastily drew them, closed the door behind 
me, and ran up the companionway. 

Near the boat-deck I came upon the 
passengers. I had read of people gray 
with fear, but I had never seen them. 
Here they were, — an admirable observa- 
tion, — a hundred women and some men, 
their faces the color of wet ashes. Seen in 
the mass, the effect was remarkable. The 
passengers behaved well. There was no 
screaming. But I was almost the only 
one dressed comme it faut. Most of the 
women had simply thrown a wrapper over 
their night-clothes. One man had on 
nothing but a suit of red pajamas — solid 
color. I went out on the boat-deck. The 
boats were swung out ; two were already 
filled; the deck was littered with coils of 
rope, over which passengers were stum- 

91 



Shock at the Front 

bling in the dark. A cold wind whipped a 
rough sea. I drew alongside the engine- 
room hatch. It was warm there, and one 
could look over the combing of the hatch 
and down into the bowels of the ship. A 
glance showed me that the ship was not 
taking water in that vital spot. 

Before long, word was passed that we 
had been in collision : another steamer had 
struck us amidships, tearing a consider- 
able hole just above the water-line. In 
half an hour we were told that we could 
go back to bed. I did so, and almost in- 
stantly fell fast asleep again. At four 
o'clock I suddenly waked. Something 
was wrong: the ship had taken a big list; 
the engines were stopped. I jumped up 
and looked out. The water was only a 
foot or two from my port. I dressed 
again and went on deck. The ship had 
been canted to keep the waves out of the 
hole, while the carpenters patched it. 

Three days later we had a tombola — a 
sale for the Red Cross. The red pajamas 

92 



Shock at the Front 

were put up at auction; they fetched six 
hundred francs. 

At length the voyage was over. I hur- 
ried to my farm — sweet haven of rest. 
I visited my Guernseys. Incredible! I 
rubbed my eyes. The cows were quite 
unchanged. Ten million men were fight- 
ing for life and an ideal, but the herbiv- 
orous poise was not shaken. 

For me, the old world had gone. 

I could not rest. I was still pursued by 
the imperious fact that shock was most 
frequent after fractures and after multiple 
wounds through the subcutaneous fat. 
I took refuge in my laboratory, in experi- 
ment after experiment. The cause of 
shock was found, and a new remedy. 

Fortune passed on, her ivory wheel half 
tarnished by the fumes of No Man's Land. 
I followed her again to France, to test 
this remedy, and to measure the blood- 
pressure in a fierce battle, during a barrage 
more violent than the worst in the great 
drive on Verdun. 



CHAPTER VIII 

The mysteries of nature usually pre- 
sent themselves as mass problems. In 
this form they cannot be answered. They 
must first be resolved into their elements. 
But each mass problem can be so resolved 
only by minds specially trained in the par- 
ticular field in which that problem lies. 
The layman cannot do this. It is for 
this reason that even a great scientist can 
rarely give a useful answer to a question 
put to him by a layman. The layman 
presents a dozen questions in one package. 
It is as if one should ask, What is the 
cause of the Great War? 

What causes shock is also not a practi- 
cal question. It is too vague. It is nec- 
essary to extract from it a series of ques- 
tions, and then to devise for each of these 
a method by which it can be answered yes 

94 



Shock at the Front 

or no. The observation that shock often 
follows fracture of the thigh-bone is an 
obvious point d'appui. The femur, or 
thigh-bone, is the largest in the body. 
When it is broken by a shell fragment, the 
rich bone-marrow is exposed. Perhaps 
some potent chemical substance is thereby 
set free, to be absorbed into the blood- 
vessels, through which it might reach the 
brain and spinal cord, and by poisoning 
the nerve-cells produce the phenomena of 
shock. But my efforts to bring on shock 
by the injection into the blood-vessels of 
chemical substances known to exist in the 
bone-marrow had no effect. It was nec- 
essary to pose another question. 

Since the fracture of the bone is ap- 
parently a factor in shock, and since the 
absorption of a chemical substance was 
excluded, the mischief might be due to a 
mechanical agent. Now, the bone-mar- 
row is very rich in fat, and it has long been 
known that after fractures of the femur 
large numbers of fat-globules appear in 

95 



Shock at the Front 

the blood, in which the globules circulate 
until they enter the capillaries in the 
brain and other organs. When a large 
fat-globule enters one of these small, hair- 
like vessels, it sticks fast, the blood can 
no longer flow through that capillary, and 
the cells supplied by that blood can no 
longer get food and oxygen. 

All this is well understood. For more 
than two centuries observations have 
been made by pathologists on changes in 
the tissues, following the injection of fat 
into the blood-vessels of animals. In- 
deed, a condition suggesting shock has 
incidentally been observed here and there 
in the course of these studies, although 
I did not know of these chance observa- 
tions until long after my own experiments. 
No one, however, had declared or at- 
tempted to prove that the entrance of fat 
into the blood-vessels was the cause of 
shock as seen on the battlefield. The 
pathologists were after other game. They 
were interested in the anatomical changes 

96 



Shock at the Front 

in the tissues following the blocking of 
the capillaries. 

Since a falling blood-pressure is the 
outstanding symptom of shock, the proof 
demanded (i) that fat-globules should be 
injected into the vessels; (2) that the 
blood-pressure should be measured; (3) 
that the blood-pressure should fall gradu- 
ally as it does in shock; (4) that the other 
symptoms seen in wounded soldiers should 
be accurately reproduced in the injected 
animal. These other symptoms are a 
feeble and rapid heart-beat, frequent and 
shallow respiration, pallor, low tempera- 
ture, diminished sensibility, and apparent 
unconsciousness. 

On February 2, 191 7, the crucial ex- 
periment was made. An instrument for 
recording the blood-pressure in the carotid 
artery of an anaesthetized cat was arranged 
to write its record on a moving surface of 
smoked paper. When the normal pres- 
sure was in record, a little less than a tea- 
spoonful of olive oil was injected into the 

97 



Shock at the Front 

jugular vein. Thereupon the blood-pres- 
sure began to fall, and the animal soon 
showed all the phenomena of shock ob- 
served in the wounded soldier. 

My attention was then directed to the 
discovery of a new remedy. Following 
the plugging of the capillaries by fat, the 
arteries and the heart are partially emp- 
tied, and the blood collects in the veins, 
especially in the large and numerous ab- 
dominal veins. In fact, the patient may 
be said to bleed to death in his own veins, 
since the quantity of blood left in the 
arteries does not suffice for the nutrition 
of the cells of the brain and other organs. 

My first experiments were directed to 
altering the physical condition of the 
fat which had plugged the capillaries, so 
that it might pass through these narrow 
straits and thus free the channels for 
the nourishing blood. These experiments 
have not yet succeeded. Even if they had, 
they might not have proved of value in 
established shock. The plugging of the 

98 



Shock at the Front 

blood-vessels undoubtedly sets in train 
the falling blood-pressure and other phe- 
nomena of shock. But the condition 
once established, the patient cannot be 
saved unless the excess of blood in the 
veins is brought back into the arteries. 
If that can be done, experience shows 
that the patient will usually recover. 
Either the stopped capillaries free them- 
selves, or other capillaries take up the 
duties of their injured neighbors. The 
practical point is to draw the blood from 
the engorged abdominal veins into the 
chest, where it will fill the half-emptied 
heart and permit that faithful organ to fill 
the capillaries. To that end, I proposed 
the respiratory pump. 

The air is drawn into the chest chiefly 
by the diaphragm, a large flat muscle 
which separates the chest from the ab- 
domen. When the diaphragm descends 
in inspiration, the cavity of the chest is 
enlarged. If a squeezed rubber ball is 
allowed to expand under water, the sur- 

99 



Shock at the Front 

rounding fluid enters the ball. So, when 
the cavity of the chest is expanded, sur- 
rounding fluids enter the chest: the air is 
sucked in through the trachea, and blood 
is sucked in through the veins. The blood 
is sucked into the chest with considerable 
force. If the normal quiet contraction of 
the diaphragm so aids the entrance of 
blood into the chest, its powerful contrac- 
tion will aid still more. Powerful and 
frequent contractions are within our com- 
mand. We have but to increase the car- 
bon dioxide in the inspired air to call 
forth deep and rapid respiration. The 
necessary amount of carbon dioxide is not 
injurious. 

These facts about the respiration and its 
influence on the circulation were known to 
every physiologist. My contribution con- 
sisted in applying them to shock. My 
remedy therefore was to increase greatly 
the action of the respiratory pump by 
having the patient breathe an atmosphere 
rich in carbon dioxide. Meanwhile he 

IOO 



Shock at t h c Front 

was to be placed in an inclined position, 
with the abdominal vessels higher than 
the heart, so as to favor by gravity the 
flow of blood from the abdomen into the 
chest. In my animals with shock, this 
increased respiration raised the blood- 
pressure sufficiently to warrant the hope 
that valuable results would follow the 
treatment when applied to wounded men. 
Upon this hope the Rockefeller Institute 
for Medical Research sent me again to 
France. 



CHAPTER IX 

On the fifth of May, 191 7, I sailed again 
for Bordeaux. The voyage was uneventful. 
Again I journeyed through famous towns 
and sunny fields in the pleasant land of 
France. The poppies cried their flam- 
ing message in the heart of the wheat — 
'Thou shalt not live by bread alone.' 

I got to Paris at sunset. My wife and 
daughter were at the Gare d'Orleans — a 
joyful reunion. Along the quai d'Orsay, 
under the plane trees beside the gleaming 
Seine, we walked to our rooms on the 
quai Voltaire. The river lay like a broad 
band of pale-green watered silk between 
the Louvre and the Quartier Latin. The 
noble arches of the Pont Royal were mir- 
rored in the mocking stream. Faintly 
shot with gold and crimson, the evening 
light faded to a luminous haze. The mar- 

102 



Shock at the Front 

chands de livres locked their begging wares 
in the little cases on the parapet. The 
gardens of the Place du Carrousel breathed 
like the sweet South upon the dying day. 

Five days later I was walking with 

Major C under fire over the gently 

rising terrain leading to the Massif de 
Moronvillers. It was my purpose to try 
the new remedy, and to measure the 
blood-pressure in normal and wounded 
soldiers during a sharp offensive. 

The meadow larks were singing. Even 
the major sang. And the air above was 
filled with the song of shells. The several 
harmonies were stratified. From the lush 
grass of early spring rose small chirpings 
and hummings; then came the major, 
having as it were a layer all to himself; 
then the meadow larks, numerous and 
undismayed; still higher were the hissing 
three-inch shells; and far, far up in the 
blue the mournful droning of the great 
projectiles. 

Tf you search these fields,' remarked 

103 



Shock at the Front 

the major, 'you will find in every square 
metre at least one piece of shell.' 

It was true. I looked through fifty 
square yards or more, and in each was at 
least one fragment of steel. 

'It is forbidden to walk in these fields,' 
said the major. 'Perhaps we had better 
get into the trench.' 

I took a last general view of our posi- 
tion. Behind us, the German fire was 
painting with dark smudges the village 
through which we had just come. Far 
across the plain — too far to see — lay 
Chalons-sur-Marne. To the left, miles 
away, was the Montagne de Rheims, 
bearing on its fruitful slopes the cele- 
brated vineyards of Champagne. In 
front, rose the Massif de Moronvillers, 
crowned with its hills of fame — Mont 
Cornillet, Mont Blond, Mont Haut, the 
Casque, and the Teton. Their decent gar- 
ments of green were torn away. Naked 
they lay. On their livid slopes the trenches 
crawled like great white worms. Streaks 

104 



Shock at the Front 

of flame and sudden bursts of black smoke 
marked the constant fall of German shells. 
Thrown high in the air, the pale chalk- 
dust drifted with the acrid fumes among 
the riven pines. 

We entered the communication trench 
— a deep and narrow passage writhing 
through the chalk like a snake in pain. 
When we came to the lines, the trench 
sank into a gallery. Dug by the Boche, it 
now served his enemy. The gallery was 
seven feet wide. At the farther end were 
four or five wooden bunks in which the 
Staff slept. In the middle were two 
tables. One supported a pair of type- 
writers, industriously nibbling at a mound 
of papers, under a small acetylene flare. 
On the other table was a row of aluminium 
porringers, salt, pepper, war-bread, and a 
small bowl of sugar. 

We lunched. The colonel was a smiling, 
energetic veteran of forty-five, hard and 
fit. His face glowed like a dull red coal in 
the shadows of the cave. Six galons were 

105 



Shock at the Front 



on his sleeve — one for each of his six 
wounds. 

The food was simple but sufficient. 
The ritual of the dejeuner was scrupu- 
lously observed. It was as if a gentle- 
man handed a poor relation into a car- 
riage. The colonel and I sat side by side. 
Conversation flowed like milk in the Land 
of Canaan. The subject indeed was cows. 
It appeared that the regiment possessed 
a cow. This was unusual. The Marseil- 
laise, the Ten Commandments, and Our 
Cow seemed to be on the same plane. As 
a breeder of Guernseys, these discerning 
people moved my heart. We were friends. 

When night came, I took off my boots, 
belt, and helmet, and slept on a stretcher. 
At half-past three, an imperative hand 
shook my shoulder. 'Gas! Be quick!' 

I seized the mask, which changes the 
man of peace into the ghoul of war. I 
pulled on my boots and put on my helmet. 
We ventured out. On the crest of the 
Massif, the stars of God paled before the 

106 



Shock at the Front 

star-shells of the Huns. It was the hour 
before dawn. A lively bombardment was 
in play. Cocks crew, still faithful to 
their conviction that, but for them, the 
sun would not rise. I reflected that, but 
for us and our seven million comrades, the 
sun might set never to rise again. We 
sniffed the cool damp air for the odor of 
chocolate which betrays the creeping 
death. But the gas was not for us. 

Far down on the horizon hung the 
gibbous moon. Across her chill and dis- 
approving face passed black slim shapes 
incredibly swift — eight-inch shells plung- 
ing to their rending crash. 

Back in Division Headquarters, Gen- 
eral F had at first suggested that I 

should be stationed in the celebrated 
tunnel on Mont Cornillet, taken from the 
enemy four days before my arrival. The 
tunnel was deep in the chalk. It was very 
large — large enough to hold a dressing- 
station and six hundred German reserves. 
It had a big ventilating shaft. By a 

107 



Shock at the Front 

strange chance, a sixteen-inch French 
shell passed through this ventilating shaft 
and exploded among the Boches. All 
were instantly destroyed. Compara- 
tively few showed a wound — they were 
killed by the gas-pressure and the fumes. 

The commotion made by an exploding 
shell is extraordinary. I have often felt 
the strong push of hot gas as if I had been 
struck by a flying cushion. Among my 
friends in Paris was a French aviator who 
had begun the war as an infantryman. 
His platoon held a first-line trench. A 
Busy Bertha fell among them. Some were 
killed by flying fragments, others by the 
concussion. A comrade of my friend was 
pushed by the blast against the hard clay 
wall of the trench, with such force that 
both the skull and the chest were crushed. 
They were visibly flattened. 

The incident of the tunnel was cer- 
tainly remarkable. But a still stranger 
accident had befallen the French a few 
days before my arrival. The regiment 

1 08 



Shock at the Front 

brigaded with the 365th had its head- 
quarters in a gallery thirty feet below the 
surface. It was apparently quite safe. 
Two large shells fell on that spot. The 
first made a crater fifteen feet deep di- 
rectly over the gallery. The second fell 
exactly in the bottom of this crater, broke 
into the refuge, and killed the colonel and 
the officers who were with him. 

I now transcribe from my diary. 

May 23. It was fortunate for me that 
I was not put in the Mont Cornillet tun- 
nel but in a cave on Mont Blond; had I 
been in the tunnel, I should have missed a 
wonderful experience — the battle on the 
crest. I was conducted to my new home 
the morning of the gas alarm. My cave 
was on the slope of Mont Blond, a little 
more than a thousand feet from the crest. 
Perhaps three hundred feet below us the 
slope ended in a path, and beyond rose 
another low hill, near the top of which 
was the regimental headquarters I had 

109 



Shock at the Front 

just left. The cave had been dug by the 
Germans. The roof was almost flush 
with the surface. There was nothing to 
mark the spot, except that the universal 
wrack was there accentuated. 

Battered tins, coils of barbed wire, 
scraps of leather, a broken stove upside 
down, rusted clips of cartridges, burlap 
sacks mired with clay, decayed bandages, 
a hopeless old rifle, intrenching tools, dis- 
carded helmets punched with shell-holes 
through which the owner's brains had prob- 
ably oozed, old shoes, battered shell-cases, 
and a trench torpedo lay about, half-bur- 
ied in the dirt thrown out of the craters. 

Five or six steps screened with dead 
branches led into the cave. It was about 
six feet deep. The roof was supported by 
projecting beams. The sides were clum- 
sily boarded. Here and there were open- 
ings dug farther into the earth and pro- 
vided with shelves which were covered 
with accoutrements, flat circular wine- 
flasks in canvas, tin cups, musettes lumpy 

no 



Shock at the Front 

with a miscellaneous kit, packages of food, 
bundles of dressings — all in great con- 
fusion and all thickly smeared with dirt. 
The furniture consisted of a couple of 
benches and a greasy table. The table 
stood against a wall. On one end were 
the surgical tools, bandages, packets of 
gauze, etc. On the other, three or four 
small cooking utensils and an alcohol lamp. 

The room was full of men: three sur- 
geons and eight or nine brancardiers in a 
space ten by twelve feet. A ladder led into 
a lower cave, six by seven feet, the floor 
of which was fifteen feet below the sur- 
face. Here were bunks of unplaned 
boards. Twenty feet away was another 
shelter, an overflow, still more primitive. 

In our own cave, dinner was being 
prepared. Dinner was served here at 
noon, for greater convenience. Outside, 
the Boches were very active. The slope 
was being searched with shells in the thor- 
ough German way. The living heeded 
this mortal rain no more than the stoic 

in 



Shock at the Front 

dead, who lay about us, beneath their 
crosses — two rough boards in the form 
the Prince of Peace had sanctified. 

Through the hot fire appeared the 
major, very brisk, clean-shaven, immac- 
ulately clothed, plump and smiling. Under 
his arm was a long bottle, converted to 
the ways of innocence. The major made 
a gay salute. 'The colonel presents his 
compliments and hopes you will accept a 
litre of fresh milk.' Delightful colonel! 
O gentle cow, all red and white! We 
drank an English toast with gusto: 'To 
hell with the Huns !' Everybody laughed. 
The bearded poilu detailed as chef plunged 
his great spoon into the tub of solid alco- 
hol at his feet and fetched up a huge lump 
to feed the flame under our crackling 
meat, as who should say, 'This for the 
Boches!' 

Dinner was served. The few who could 
find a place sat down. The rest stood, 
each with his porringer. We had hors 
d'ceuvres, consisting of sardines and sliced 

112 



Shock at the Front 

onion with bread and butter, omelette, 
beef with sauce tartare, potato salad, 
oranges, and cakes. Jokes flew about, 
but they were harmless jokes. Neither 
then nor at any other time did I hear from 
French soldiers the coarse obscenity which 
too often mars the fighting men of other 
nations. 

In the afternoon, I went with an officier 
de sante into the advanced trenches. But 
trenches is not the correct term. The 
Germans had been forced back and off the 
whole extent of the Massif de Moronvil- 
lers, until they had lost all the crest but 
the position immediately above our cave. 
The French first line lay beyond the old 
German trenches, in a series of shell-holes 
connected by hasty ditches. It was very 
warm here ; in some places w r ere more dead 
than living. The commandant of this sec- 
tion complained to my officier de sante. The 
dead were not removed quickly enough. 
He could sentir them. They had begun 
to rot. 

113 



Shock at the Front 

We returned safely to the cave. As 
we stood at the entrance, a German plane 
passed high over us. We dived for shelter. 
Xone too soon. A moment later three 
shells fell, one after the other, close to our 
post. These caves are not proof against 
direct hits, though safe enough from 
fragments. Two days after my departure, 
a shell entered the poste de secours next to 
ours, killing the two surgeons and five 
brancardiers. 

There are hours when the fire is light, 
although it never ceases. Again, it will 
swell almost to drum-fire. It is not safe 
to go more than a few feet from the cave, 
lest you be caught in one of these sudden 
storms. When it is possible, I sit in the 
mild May sunshine on a burlap at the top 
of our steps. The probable course of a 
shell can be told from the sound it makes. 
When the hiss crescendo seems to be com- 
ing straight for you, a swift plunge is in 
prder. A sharp watch for planes is neces- 
sary. In my first summer, at Xieuport 

114 



Shock at the Front 

and elsewhere, the planes did not usually 
attack small groups of soldiers. But 
here, at the Massif de Moronvillers, they 
have a nasty habit of dropping suddenly 
from the sky, spitting steel from their 
mitrailleuses. 

The gas-shells are very numerous and 
very deadly. My colonel --the one who 
sent the milk — was laid up three weeks 
from gas which had crept through a very 
small opening where, because of his high 
cheek-bones, the edge of the mask failed 
to press firmly against his face. Our 
masks contain several layers of gauze 
saturated with different chemicals to 
neutralize the various fumes. 

When darkness came we prepared for 
bed. At half-past eight my orderly 
saluted. He had been before the war a 
teacher of Latin in the High School at 
Lille. His wife and two children were 
refugees. The wife had tuberculosis from 
her hardships. He informed me in his 
precise French that my couch was ready. 

"5 



Shock at the Front 

I climbed down the ladder to the lower 
cave, backwards and bent double, since 
the entrance was a low slanting shaft. 
Gerard pulled off my great trench-boots, 
hung up my belt and helmet, and folded 
my raincoat for a pillow. I lay down on 
the bare planks. He placed my heavy 
overcoat over me and wished me pleasant 
dreams. I told him that in my youth I 
had often been put to sleep by a teacher 
of Latin, but I had never before been put 
to bed by one. 

During the night, the Boches bom- 
barded points below us with gas-shells. 



CHAPTER X 

May 24. This afternoon, at three, the 
French began to prepare for storming the 
crest of Mont Blond. In the course of 
an hour the Germans made up their mind 
that an assault was intended. The artil- 
lery fire, which had been continuous be- 
fore, now swelled to a torrent. Each side 
placed a barrage. The German barrage 
covered our slope and the little valley 
between us and the top of the next hill. 
Between four o'clock and midnight, more 
than 10,000 heavy shells fell within a 
radius of a thousand feet from our cave. 
I took the count from time to time with 
my watch. 

We were driven at once into our deeper 
refuge. The little stuffy hole was packed 
with men, knee to knee: stretcher-bearers, 
surgeons, my orderly, and myself. The 

117 



Shock at the Front 

three surgeons played baccarat. I sat on 
the edge of a plank and watched the game. 
We had an acetylene light. The shells 
fell all around, shaking the place and 
repeatedly putting out the light. The 
noise was remarkable. The air was filled 
with screams, hisses, and loud reports, 
followed by the slide of masses of earth. 
Many shells were so close that a strong 
push of hot gas was felt. At six o'clock 
the Moroccans took the ridge by storm. 
At midnight the bombardment slackened 
but did not cease. 

With the dawn the wounded came in 
a stream. They were laid in the upper 
room. The wounds were of all sorts. 
The worst was a completely crushed jaw, 
in a man with a dozen slighter wounds. 
One man had a hole through the temple 
into the brain — a hole two inches long 
and half an inch wide. Another had a 
smashed leg, a bad head, and in the thigh 
a wound the size of a small orange. 

I watched the blood-pressure carefully. 

118 



Shock at the Front 



Imagine a cellar with a plank floor covered 
with clay an eighth of an inch deep. A 
horrible tub filled with bloody dressings. 
Two stretchers on the floor. Ten men in 
a space ten by twelve feet, shoulder to 
shoulder. Two candles. Sand-bag walls. 
The roof so low that I am always hitting 
my helmet against the beams. The air 
thick with the smell of blood, sweat, 
alcohol, iodine, vomit. Everywhere a 
smear of clay — the chalky clay of Cham- 
pagne. The continuous scream, roar, 
crash of shells. A rain of small stones, 
dirt, pieces of steel. Every few seconds 
a profound trembling, as a shell strikes 
closer. Four men passing bandages and 
iodine in the half-light, over backs, under 
arms. The cries of the wounded. The 
litter of bloody garments. The fresh 
cases, obliged to lie outside, under the 
fire, until the room is cleared. The bran- 
cardiers, bent under the load of the 
stretcher, slouching off with the dressed 
wounded. The dawn, the failing moon, 

119 



Shock at the Front 

the thick vapors and acrid stench of the 
barrage. The blasted hillsides smoking 
under the continual rain of death. Count- 
less fresh shell-holes all around us. The 
graves reopened . They are bringing down 
the dead. — They lie sprawling on the slope 
just below us, half sewed up in burlap, like 
pieces of spoiled meat. 

Such was the battle for the crest — a 
'minor operation' in this great war, but an 
excellent example of the most violent ar- 
tillery fire. The blood-pressure remained 
normal, not only in the unwounded men, 
but also in the wounded. As it happened, 
there were among them no fractured thighs 
and no case of multiple wounds through 
the subcutaneous fat. 

May 25. To-day two or three rather 
elderly soldiers came in, with the plea that 
they were sick. The doctor, who has a 
soft full beard, large brown eyes, and a 
very gentle manner, said, 'You are not 
sick. You are only tired. But all the 
world is tired here.' 

120 



Shock at the Front 

During the evening, one of our own 
shells fell short. It struck squarely in our 
own trenches near the crest of Mont Haut. 
Immediately went up two rockets, each 
with three green flares, meaning 'Great 
Jerusalem! Lift your nose.' Thus ad- 
monished, the humiliated seventy-five 
raised its muzzle and the next shell fell 
over the ridge. 

May 26. Just before daybreak there 
was drum-fire — continuous roars from all 
the batteries. This lasted two hours. I 
got up and crawled into the upper cave, 
but was at once driven down again. After 
the fire slackened, I went out — about two 
feet out — and Gerard prepared my toilet 
— a shave and face-wash. I have not had 
any of my clothes off during three days 
and nights. After shaving, I went out to 
brush my teeth. The air was clear and 
brisk, the sun not yet fully risen. To stand 
on the open slope of the hill, in the keen 
wind of dawn, under fire, and use a tooth- 
brush was really exhilarating. It was the 

121 



Shock at the Front 

first time I have ever enjoyed brushing my 
teeth. 

At nine o'clock, we put a barrage on 
Fritz. At this he quite lost his temper. 
The noise was awful. Naturally, we 
went 'down' again. But his rage lasted 
only a short time. Then G6rard came to 
tell me there would be a Mass in the lower 
cave. 'Is there a priest among you?' I 
asked. 'Yes,' replied Gerard, 'we have 
two ones; the both very brave.' 

The Mass was a touching ceremony. 
The early Christians worshiped thus in 
the catacombs of Rome. A very small 
portable altar had been placed at the end 
of the tiny passage. Two candles burned 
upon the altar. The men stood elbow to 
elbow or kneeled in the bunks — martyrs 
not yet dead. The priest was a private 
in the infantry. Over his dirty uniform 
of horizon blue — the faded symbol of 
worldly hope — he had drawn the vest- 
ments of the Church that teaches Hope 
eternal and unsoiled. His grave strong face 

122 



Shock at the Front 

was lighted with sincerity and faith. The 
clear word of promise and of consolation 
mingled with the roar of German shells, 
beasts seeking whom they might devour. 

About ten o'clock, the major turned up 
to fetch me to dinner, or dejeuner, at 
Headquarters. It was to be my farewell 
to Mont Blond. He had a great stereo- 
scopic camera, with which he took my 
picture standing at the mouth of the cave. 
Then we went off, with Gerard and an- 
other orderly to carry my things. The ma- 
jor has a quick and almost jaunty walk. 
In ten minutes we arrived at the poste. 

An officer went with me up to the observ- 
atory, a pit in the chalk on the top of the 
hill. The breeze was fresh, the sunshine 
delicious, and the view very extensive. 
Behind us, the slopes of Mont Blond and 
Mont Haut, smoking with shells, white 
with craters, trenches, and dust. In front, 
the plain of Chalons, green and smiling, 
with the spire of a church, and the vil- 
lages of Mourmelon-le-Petit and le Grand. 

123 



Shock at the Front 

To the right, the Montagne de Rheims, 
with Epernay and its vineyards. 

After that diabolical cave all this was 
very sweet to me. I dozed in the sun, 
when suddenly a soldier, who was digging 
near us, threw down his tool, and with a 
warning cry rushed under cover. We 
jumped for our lives. An aeroplane sailed 
over us, half a mile up. 

A hawk is hovering in the sky — 
To stay at home is best. 

After a delightful hour we returned to 
the gallery for lunch. It was quite a 
feast. There was one white plate, pro- 
duced in my honor. The rest ate the 
whole meal out of one aluminium por- 
ringer apiece. It is useful to eat each 
course clean, to scour the porringer with 
bread, and then to eat the scourings. 

After an excellent meal, I set out for 
Mourmelon-le-Petit. Two officers went 
a little way with me. It was hard to part 
with such kind friends. For success with 

124 



Shock at the Front 

these people there are three points to be 
observed — to be perfectly brave, to be 
always smiling and gay, and to be en- 
chanted with your bed, your food, the dirt 
— in short, with everything. Fortunately, 
I do not mind shelling; few men do. 

The walk across the plain to the Farm 
of Constantine, where the motor-ambu- 
lances wait, was not unpleasant, though 
a battery of seventy-fives directly en face 
made a deafening racket. The ambu- 
lance driver, an Englishman, worn, pre- 
maturely gray-haired, covered with dust, 
had lived for years at Stockbridge, Massa- 
chusetts, and knew my friends there well. 
He was very cross about the gas-shells: 
he could not see to drive with his mask on. 
After a dazzling, dirty ride, we reached 
the ambulance de triage at Mourmelon-le- 
Petit. Here are brought all the wounded 
from the postes de secours at our immedi- 
ate front. It will be a good place to try 
the respiration method for the treatment 
of shock. 

125 



CHAPTER XI 

May 27. Mourmelon is a small village, 
justly called ' le Petit.' Its glaring streets 
are white with lime-dust, which indeed 
lies everywhere. The dirt is inconceiv- 
able. The ambulance consists of a num- 
ber of old barracks in a walled compound. 
On my arrival, the medecin chef gave me a 
very kind welcome. He is a bacteriolo- 
gist by profession, and before the war was 
Assistant Director of the Pasteur Insti- 
tute in China, where he had met my col- 
league, Dr. Strong, during the pneumonic 
plague. 

I sleep alone in a small ward. My 
ward has five beds, a wooden floor thick 
with dirt of all descriptions, and painted 
canvas walls. Naturally, the furniture 
is crude. But what a delight to strip 
once more and to bathe in clear cold 

126 



Shock at the Front 

water — about one quart! Last night I 
slept hard, but to-day I feel the strain 
of the terrible scenes which I have been 
through. 

After supper, the m6decin chef and I 
took a long walk over the Field of Chalons. 
It is a green almost level expanse, tra- 
versed here and there by roads lined with 
trees. The sun had set, the air was cool 
and luminous. The cannonade seemed for 
the first time without sinister meaning. 
The plain was covered with small shell- 
holes. In the distance, on rising ground, 
against the horizon, galloped a train of 
limbers bearing ammunition for the in- 
satiable cannon. 

May 28. I am very tired. The glare, 
the dust, the endless stream of broken 
men, — ten thousand passed here in the 
last six weeks; one hundred and sixty- 
five last night between midnight and 6 
A.M., — the necessarily great inadequacy 
of treatment — all this, added to my reac- 
tion from the sickening scenes on Mont 

127 



Shock at the Front 

Blond, is sufficiently depressing. I have 
had to think today. That was a bore. 

The respiratory machine has under- 
gone a transformation. It is now, in 
fact, a tomato-can with a tube ending in 
a rubber mouthpiece. It has been cut in 
two and each half shoves over a collar of 
tin, so that it may be drawn out like an 
accordion. The patient is to breathe 
in and out of this can, filling it with the 
carbon dioxide he exhales. As the gas 
increases, so will his respiration. To wash 
the can with fresh air, the two halves are 
pulled apart. Nothing could be simpler. 

This hospital is a triage. It sorts the 
wounded. Those who can be moved are 
sent in suitable lots to Chalons and else- 
where. One hospital specializes in ab- 
dominal wounds, another in fractures, and 
so on. Only the most mangled are oper- 
ated here. The shock cases are among 
them. 

To-day I was presented to General 

X , one of the high command here- 

128 



Shock at the Front 

abouts. He is a man about five feet 
seven, very slim, very fit, intelligent, 
courteous, handsome uniform, great star 
on his breast. He was pleased at my 
having been in the barrage. He said it 
had been a very severe action — acharne. 

Our medecin chef is very kind — much 
interested in my physiology — helps me 
with everything himself — says he is at my 
disposition day and night. But it is an 
awful load; there are such numbers of 
these battered fragments, and I know so 
little. It wrings the soul. A fine young 
officer came in to-day — shell in the abdo- 
men. I wish I were at home, with you. 
I shall never be able to get these sights 
and sounds out of my mind, or the smell 
of rotting flesh out of my nose. 

May 29. To-day, the chief and I tried 
an experiment on a blesse with multiple 
shell-wounds and very low blood-pres- 
sure. It was a failure. The respiration 
was not increased, and the blood-pressure 
was not raised. Neither was the chief's 

129 
10 



Shock at the Front 

opinion of the method, although he was 
much too wise to be skeptical. My spirits 
were not elevated by the occurrence. 
Last night I was very tired. Indeed, I 
am tired to-day also. My bed is next a 
great ward rilled with wounded, only a 
canvas wall between. Promptly at day- 
break one of these sufferers begins to call, 
'Garcon! Garcon!' The monotonous, 
feeble, penetrating wail rises with clock- 
like regularity every few moments until 
broad daylight. There are no nurses here, 
only ignorant poilus. 

This afternoon I got a soldier as sub- 
ject and tried the machine in the presence 
of several deeply attentive officers. Noth- 
ing doing. The breathing remained al- 
most calm. Immense shrugs from all 
beholders. I do not see why it should 
work on animals and not on men. They 
brought me another man, a finely built 
youth, and intelligent. Another failure. 
This time the shrugs were so exaltes that 
I thought the spectators would put out 

130 



S h o c k at the Front 

their tongues at me. Then the soldier 
said, 'But, monsieur le major, my nose is 
still open.' 

O clever youth! Inspired young man! 
The officer whose duty it was to stand 
guard at the nose had put the clip too 
high up. Ten hands reach the recalci- 
trant organ. I look to see the nose 
pulled off. But no. It successfully resists. 
This time it is stopped for sure. The 
youth announces thickly that he can 
breathe only through his mouth. 

The instrument is now applied to the 
mouth. Listening to the artery, I get 
for a base measurement a clear bruit just 
above the minimum normal blood-pres- 
sure. ' CommencezV I cry. Off we go. 
In fifty seconds, he is pumping merrily. 
The heart bounds. The blood-pressure 
goes up. Three cheers for Us Etats-Unis. 
Bring back the first rebel. His nose is 
closed this time. It is all but squashed 
flat. Again a success. Voild! Cest fini. 
Profuse thanks to the experimentes. Con- 

131 



Shock at the Front 

elusion: another triumphal demonstration 
that men are like dogs. 

May 30. It remains now only to get 
a couple of smashed thighs with low 
blood-pressure. It is practically certain 
that we shall have a rise also with them. 
They may come in any minute. It is 
very calm to-day. No cannonade to speak 
of. This morning the Boches dropped 
three shells on the railway station about 
two minutes from here. But their aim 
was good ; they did not hit us. Just above 
me is a hole in the roof through which a 
shell fell a few weeks ago. A fragment 
sailed out the front door, narrowly missing 
the medecin chef. 

This waiting is slow work. I am writ- 
ing in the big pavilion de reception. It 
was a soldiers' theatre. It is here that the 
sorting takes place. On the dirt floor, 
near my feet, lies a soldier on a stretcher. 
He has had a heavy thump on the chest 
and breathes with difficulty. Between us 
is a great brazier, half-full of red-hot coke. 

132 



Shock at the Front 

The air is keen to-day. Tea is to be served 
for me at four o'clock. As I speak English, 
they fear I should die without my tea. I 
wave my hands, but it is no use. After 
our dinner, we drink a hot decoction of 
the blossoms of the lime tree. They firmly 
believe that it helps the digestion. Who 
can refute it! The connection between 
faith and peristalsis is too strong to be 
denied. 

The chief regrets that there are no wo- 
men here. He thinks they would help 
the service. They would no doubt teach 
these poilus how to wash. Such dirt! 
The chief has lent me a clothes-brush. 
'It is for the horse,' he explains, 'but I 
believe the brush for the horse is better for 
man than the brush of the shops.' Mon 
avis: I shall need a currycomb soon. 

May 31. To-day there were several 
cases of shock. I tried the respiratory 
machine. It did not work. All the 
muscles of these poor creatures were re- 
laxed. Their lips would not close on the 

133 



Shock at the Front 

rubber mouthpiece. I am off for Paris 
to-morrow, to have made a frame en- 
closed in a kind of bag. The patient's 
head will go inside and carbon-dioxide 
gas will pass into the chamber from a pres- 
sure cylinder. The bag will be tied round 
the neck. The new device will have two 
advantages. First, the patient will have 
nothing to do but to breathe; he need not 
close his lips on a respiration tube. Sec- 
ond, the treatment need not be inter- 
rupted to wash out the apparatus with 
fresh air. There will be plenty of car- 
bon dioxide and a hole can be left in the 
chamber, through which the patient can 
get all the oxygen he needs. But prob- 
ably by the time this apparatus is made 
and tested, the fighting in this region will 
have quieted down. It would then be 
necessary for me to go elsewhere. 

My stay at the Massif de Moronvillers 
has been very profitable. I have demon- 
strated that the blood-pressure is not al- 
tered by a barrage fire said to be as 

134 



Shock at the Front 

violent as the worst in the great drive at 
Verdun. Further, I have myself exam- 
ined more than a thousand wounded. 
Save a few wounds of the abdomen, in 
which the blood-vessels or their nerves 
in that great vascular region were prob- 
ably directly injured, there has been no 
case of shock except after shell-fractures 
of the thigh and after multiple wounds 
through the subcutaneous fat. In these, 
closure of the capillaries by fat-globules 
is known to take place. This is strong 
support for my discovery that shock may 
be produced in animals by injecting fat 
into the veins. 



CHAPTER XII 

As might have been expected, the mak- 
ing of the new apparatus in Paris in war- 
time was a slow business. When it was 
finished, I tested it at the College de 
France in the laboratory of my kind friend, 
Professor Gley. It worked very well. A 
wire frame covered with a thin caout- 
chouc bag enclosed the head. Carbon- 
dioxide gas passed into this bag from a 
pressure cylinder controlled by a regulat- 
ing valve. On its way, the gas bubbled 
through a flask half filled with water. 
The rate of passage could be told by 
counting the bubbles. When the inspired 
air contained about three per cent of 
carbon dioxide, the subject's respiration 
was doubled and the blood-pressure was 
plainly greater. Sufficient fresh air was 
obtained through an opening in the bag. 

136 



Shock at the Front 

By this time the fighting at the Massif 
de Moronvillers had sunk to the habitual 
offensive; there were no longer enough 
wounded at Mourmelon-le- Petit. As only 
one in a hundred casualties has shock, I 
needed at least one hundred wounded a 
day. Since the point at which attacks 
might be made could not be foretold, it 
was necessary to obtain carte blanche to 
go anywhere on the French front. For 
this I went to Grand General Headquar- 
ters at Compiegne. 

In my former days at Compiegne, the 
great Chateau had been a sleepy place, 
almost deserted. It was now the seat of 
Grand General Headquarters. No doubt 
it would be profoundly altered. There 
would be many guards, a stream of 
officers coming and going, a crowd of auto- 
mobiles, a rush of aides bearing messages. 
To my astonishment, it was scarcely 
changed. This centre of perhaps the 
greatest intellectual activity in the world 
was as quiet almost as the grave. A 

137 



Shock at the Front 



lonely sentinel guarded the iron gates. A 
single limousine stood within the court; 
the chauffeur dozed in the warm June 
sun. 

Madam C and I were admitted to a 

tiny room, economically boarded off from 
one of the salons. Presently a soldier led 
us up the ancient stairway to the third 
floor, where we traversed interminable cor- 
ridors paved with brick. We passed door 
after door, each of which bore a white 
paper stating the name and business of 
the inhabitant. We met not a soul. 

Finally, we arrived at the door we 
sought. We found within a pleasant of- 
ficer at a large desk. He might have been 
writing his memoirs, so easy and good- 
natured was he. I stated my case, while 
my benevolent companion made signs be- 
hind my back that I was some kind of rare 
bird. Even the good are full of guile. 
The officer did not penetrate this aura. 
Early the next day I received a magic 
square of blue paper, giving me full powers 

138 



Shock a t the Front 

and requiring every French officer to 
further my researches. 

Returning to the Ministry of War, at 
Paris, on the Boulevard Saint Germain, I 
obtained an order of transport, providing 
free passage and all civilities on the rail- 
ways. A message was telephoned to the 
front, ordering a limousine and an officer 
to meet me at a certain station. The next 
day I departed, in the company of an 
enormous cylinder of carbon-dioxide gas. 
I reached a station near Soissons and was 
most politely conveyed to Division Head- 
quarters. Here the general brought out 
a map on which were marked the postes de 
secours, the sorting hospitals, and other 
administrative details. Soon I found my- 
self just behind the Chemin des Dames, 
welcomed by a friendly medecin chef, in 
private life Professor of Surgery at the 
University of Marseilles. 

June 24. This is a hill country. The 
road to the Ambulance crosses a fold in 
one of these hills. On the left is a cliff, 

139 



Shock at the Front 

separated from the road by a narrow strip 
of ground holding a single line of low stone 
houses. On the right, a few others cling 
to the slope. It is Vauxtin. Below the 
village is a little valley containing bar- 
racks and stables. Beyond Vauxtin the 
road rises to a rounded summit on which 
are the great tents of the hospital. It is 
almost a motor-ambulance. Electric-light 
generators are mounted on an auto truck. 
There is an automobile dovecote, with 
homing pigeons. The tents have dirt 
floors, except in the operating-rooms. 
There is good air, much sunshine, a wide 
view, a large and competent staff. The 
surgical results are excellent. 

The staff sleep in the village — in caves 
dug in the cliff. I live in a house. It has 
a small courtyard, shut from the road by a 
wall. There is a wide gateway, closed by 
iron doors. Upon this yard open sheds in 
which are cows, swine, poultry, dogs, and 
rabbits. In the centre is a dunghill, a pool 
of liquid manure, and several indolent open 

140 



Shock at the Front 



drains. My room has a dirty brick floor, 
dirty walls with great cobwebs, and a dirty 
duvet, of a color once red. The sheets are 
coarse but clean. There is no soap-dish, 
no towel, no anything but a small bat- 
tered tin basin and a rusty tin water-can. 
The door will not lock, or even latch. 
Two dogs, three cats, and all the chickens, 
wander at intervals through the manure 
and into the chamber of the interesting 
stranger. The cats find the duvet com- 
forting. 

I am writing on our mess-table in the 
adjoining courtyard. We eat in the open, 
protected from rain by some flimsy tarred 
paper. Near my bench is a rabbit-hutch. 
Two large and fluffy hens, each with many 
chicks, are trying to teach me how to man- 
age a family. I should be more interested 
if they would show me how it is that my 
family manages me. The proprietors of 
this court are a wrinkled, leathery couple 
who are evidently moved by the example 
of the prudent Noah ; they seem to have 

141 



Shock at the Front 

at least one pair of each species of animal 
indigenous to these parts. Their owners 
think that, pending the arrival of the 
flood, it would be a waste of energy to 
clean the court. Our supper consisted 
of onion soup, omelette souffle, hash in 
slabs, green peas, lettuce salad, confiture, 
toasted war-bread, and coffee. 

At ten o'clock, the apparatus was tried 
on the medecin chef. If he does not com- 
plain, the soldiers will not. The experi- 
ment goes smoothly and the chief is en- 
tirely comfortable. 

June 25. It is nine o'clock, and I am 
sitting at the door of my shock tent, writ- 
ing on my knee. I was called at 5.45 
A.M. and worked without food till 1 P.M. 
Then an hour for dinner, and after this, 
more work till 8 p.m. Then supper and 
a pipe, and here I am. 

We have had five cases of shock. Three 
recovered; one was hopeless from the 
start ; and the fifth could not be treated — 
constant vomiting and hemorrhage. A day 

142 



Shock at the Front 

full of dreadful sights. The battles here 
are fiercely fought ; there are more than 
ten German divisions on our immediate 
front. The carbon-dioxide treatment is 
undoubtedly an advantage. Probably it 
is of considerable advantage. Just how 
much, can be determined only after many 
observations. But at least a forward step 
has been taken. 

Yesterday I went for a walk to the end 
of our plateau, separated by a few miles 
from the Chemin des Dames. It was 
dusk. The flashes of the guns, the flares, 
and the smoke-clouds were all visible. 
Many years ago, the ladies of the French 
court had villas there, and used to drive 
along the Chemin des Dames to get the 
view from the long, high ridge. 

We had a grand lunch to-day. Tuflier 
and his aide were guests. The smoke 
from the green wood of the cook's fire mer- 
cifully deadened our capacity to smell his 
stove five feet away and the manure-pool 
ten feet away. After all, the rich agricul- 

143 



Shock at the Front 

tural aroma of rabbit and cow is not so 
bad. The wrinkled peasants, proprietors 
of this demesne, enjoy these ancestral 
odors. 

Pomona loved the straw-built shed, 
Warm with the breath of kine. 

The old dame has stolen out to catch a 
glimpse of the great surgeon. She stands 
with bared head before a plastered wall, 
on which a vine has drawn a pattern of 
classic beauty. 

The lunch is interesting. An officer 
tells us his experience at Verdun. He 
might be describing the barrage on Mont 
Blond. I am comforted. He at least 
will know that I have spoken truth. Our 
feast has reached the cheese, eaten in the 
hope that its sharp savor may correct our 
earlier excesses, when the air fills with a 
series of loud bangs mixed with the bark- 
ing of pompoms. A Boche is trying to 
hit the barracks and stables down the 
slope of the hill. Last week sixteen 

144 



Shoe k at the Front 

horses were killed by a single bomb. 
This time the aviator is missing his mark. 
His bombs are falling at the edge of the 
low cliff above our heads. Our party 
leaves more or less hastily for the shelters 
under the cliff. The sensible ones run. 
Turner and I walk. After a minute or 
two we conclude that our German friend 
has done, and we sit down again. Our 
waiter fetches a jagged piece of steel that 
had struck about four feet from the 
plank on which rest my poor old bones at 
meal-time. But don't be alarmed. This 
is a quiet enough place. All the hills are 
bearing haycocks. The fields are poorly 
cared for, naturally, but there seems never- 
theless much precious fodder. 

Last night it rained, but to-day has been 
fine and cool. I hated to spend the long, 
sunny hours in an intolerably hot little 
room over the remains of what was once a 
whole man. The wounded are so patient, 
poor dears. 

Jane 27. After writing you yesterday, 

145 
11 



Shock at the Front 

I went almost at once to bed. It was still 
light. The cows and the chickens were at 
rest, but the peasants were cackling, and 
soldiers and ambulances were constantly 
passing my open window. This window 
is three feet above an open drain at the 
side of the road. Nevertheless, I was 
soon asleep — fortunately, because at two 
o'clock a hoarse voice and a rattle at the 
shutter called me to a shock case. I 
dressed hurriedly and stumbled up the 
dark hill to the ambulance. I found the 
surgeons just bandaging the stump of an 
amputated thigh. The man was pulse- 
less. The head surgeon turned him over 
to me — they always do: the more desper- 
ate the case, the more pleased they are to 
bestow him on some one else. The man 
was taken to my tent and all the surgeons 
stood by to see what would happen. He 
was placed head down on a sloping table. 
Six large electric lights were arranged be- 
tween him and his blanket. The mask 
was put over his head and the carbon 

146 



Shock at t he Front 

dioxide turned on. In three minutes his 
pulse reappeared. Every one was much 
pleased. 

I am anxious to get back to Paris to try 
out a new idea, an electrical method for 
raising the blood-pressure. 

I had come down to the Chemin des 
Dames by way of Berzy. At that time 
Berzy was the railhead — passengers did 
not go through to Soissons. My colleagues 
at Vauxtin thought it unnecessary for me 
to go back the way I had come. There 
was a nearer station, the name of which 
has escaped me. I departed for this sta- 
tion, after the most friendly leave-taking. 
The amenities have attained in France 
a perfection that is the despair of other 
nations. 

After an hour's ride I was deposited on 
the railway platform and the motor 
darted away. I asked the chef de gare 
if the train for Paris was on time. 

'Train for Paris! What train? There 
is no train until tomorrow.' 

147 



Shock at the Front 

'Oh!' said I, 'that is most unfortunate. 
My car has gone and I must be in Paris 
this afternoon.' 

'Then you must go to D.; a train 
leaves there in about two hours. It is 
twenty-five kilometres.' 

There was no time to lose. I ran out 
into the street. A lieutenant came along. 
'I am in trouble,' I explained, 'my car is 
gone. There is no train here. I must be 
in Paris before night. There will be a 
train at D. Won't you please send me 
there without delay?' 

At this he made large eyes. 'What, 
Monsieur, you ask me to — to confiscate an 
auto for you? I am desolated not to — ' 

Here I cut in: 'But I have an order 
from the Quartier General'; and I pro- 
duced the Magic Square of Blue Paper. 

At that instant, a handsome limousine 
glided down the road, with two soldiers 
on the front seat. My lieutenant waved 
his hand. The car stopped. The sol- 
diers saluted. 

148 



Shock at the Front 

'Take this officer to Headquarters at 
C Turning to me he said, 'It is ten 
kilometres on your way. At Headquar- 
ters you can get another car.' 

In I jumped, with a word of thanks and 
my very best smile, and we were off at 
thirty-five miles an hour. In less than 
fifteen minutes we were at Headquarters, 
a handsome old house in a small village. 
I was taken to a door, on which I knocked. 
It opened and revealed two charming 
gentlemen. 

'I am Professor Porter,' I said. 

'Ah,' they replied, with the pleased and 
deferential air of a naturalist confronted 
with a new species. 

' I must be in Paris this evening. There 
is a train leaving shortly, fifteen kilo- 
metres from here.' 

'Monsieur is well informed.' 

A pause, with rather cryptic smiles. 

' Pardon, messieurs, you have no autos?' 

' But yes ; we have. Only — Monsieur will 
excuse — our autos are not for the public.' 

149 



Shock at the Front 

'Perfectly,' I rejoin, 'but, chers mes- 
sieurs, I am not the public. I have an 
order from the Grand Quartier General.' 

The officers wasted no time. One 
handed me a chair; the other seized the 
telephone. In two minutes I was flying 
over the road in a powerful racing car. 

In the zone, a magic square of blue 
paper is better than much gold. 



It is not my present purpose to give an 
account of the busy weeks that followed 
my return to Paris, or to describe in these 
pages the long series of experiments in the 
College de France. I found an electrical 
method useful against shock in animals, 
but I have not yet succeeded in adapting 
this method for use upon man. 

In August, 1 91 7, I sailed for my own 
country, bearing with me the certainty 
that fat embolism is a frequent, if not the 
most frequent, cause of shock as seen on 
the battlefield; and the further certainty 

150 



Shock at the Front 

that the carbon-dioxide respiration treat- 
ment is of advantage. 

Continued investigation is a sharp and 
pressing need. These monstrous mala- 
dies devour our sons. Unchecked, they 
drag the stricken hero 

Through caverns measureless to man, 
Down to a sunless sea, — 

a sea of sorrow — sad extinction of the 
tremulous hopes with which we crown our 
dear and precious youths. Pierced by the 
iron shards of a perverted science, they 
can be rescued only by science undefiled. 

Our people drowse. They sleep, like 
fallen angels, on the marl that hides con- 
suming fires. Awake! Arise! Multiply 
research ! Forge the weapons which alone 
shall save the lives of those who fight our 
battles ! 

Our hearts are in their keeping. 

The End 



OTHER VOLUMES IN THE SERIES OF 
ATLANTIC PAPERS 



HEADQUARTERS NIGHTS 
Bv Vernon Kellogg 



When the World War broke out, Vernon Kellogg was 
Professor of Biology at Leland Stanford University. As 
a man of science, he was accustomed to weigh facts 
calmly and dispassionately. He was an admirer of 
Germany, a neutral, and a pacifist. With the hope of 
relieving human suffering, he went to Europe and 
became special envoy of the Committee for the Relief 
of Belgium at German General Headquarters and at 
the headquarters of General Von Bissing in Brussels. 

For many months, Professor Kellogg lived with Ger- 
many's military leaders in the West, worked with them, 
argued with them, learned from their own lips their 
aims and principles of life. He saw the workings of 
German autocracy among the people it had crushed, 
heard German methods defended by some of the ablest 
men in the Kaiser's empire, tried in vain to understand 
the German point of view. 

"Quite four nights of each seven in the week," he 
savs, "there were other staff officers in to dinner, and 
we debated such trifles as German Militarismus, the 
hate of the world for Germany, American munitions 
for the Allies, submarining and Zeppelining, the Kaiser, 
the German people." 

These "headquarters nights," and the days he spent 
trying to assuage the misery caused by the German 
military system, brought about "the conversion of a 
pacifist to an ardent supporter, not of War, but of this 
war; of fighting this war to a definitive end — that end 
to be Germany's conversion to be a good Germany or 
not much of any Germany at all." 

One of the most graphic pictures of the German attitude, the 
attitude which rendered this war inevitable, is contained in Vernon 
Kellogg's Headquarters Nights. It is a convincing, and an 
evidently truthful, exposition of the shocking, the unspeakably 
dreadful, moral and intellectual perversion of character which 
makes Germany at present a menace to the whole civilized world. 

Theodore Roosevelt. 

Headquarters Nights is attractively printed and 
bound in cloth. Its price is one dollar postpaid. 

The Atlantic Monthly Press 

Three Park Street, Boston, Mass. 



THE WAR AND THE SPIRIT OF YOUTH 



This book is a spiritual interpretation of the suffering 
and sacrifice of the World War, expressed in a group of 
three papers of kindred significance, yet written from 
three different points of view by a Frenchman, an 
Englishman, and an American. The volume includes: 

Young Soldiers of France, By Maurice Barres. 
Juventus Christi, By Anne C. E. Allinson. 
The Soul's Experience, By Sir Francis Young- 
husband. 

Each writer is seeking in the dreadful welter of war 
some common revelation of spiritual comfort and ad- 
vance. Is the agony of these years meaningless and 
wanton? Is the heartsickening struggle brutal and 
brutalizing, and nothing more? Each, in his or her 
own way, finds an answer. 

One, a questioner by temperament, has come to see 
the regeneration of human life in the miracle which 
the war has worked in the younger generation. An- 
other, by profession a soldier, found a new and vivid 
faith born of physical impotence and pain. The third, 
an American woman, has come to her new belief from 
far distant fields of the imagination. All three unite in 
confidence that the generation now culminating in man- 
hood is passing through blackness into light brighter 
than any dawn the world has known. 

The spirit of the volume is the spirit of youth, learn- 
ing in the Book of Life, trusting that the best is yet to 
be, and reading with shining eyes to the end. It is the 
spirit of Leo Latil, a young soldier of France, who, 
shortly before his death on the edge of a German 
trench, wrote to his family, — 

Our sacrifices will be sweet if we win a great and glorious victory, 
— if there shall be more light for the souls of men ; if truth shall come 
forth more radiant, more beloved. 

The War and the Spirit of Youth is an inspiring, 
heartening little volume. It is well printed, hand- 
somely bound, and sells postpaid for one dollar. 



The Atlantic Monthly Press 

Three Park Street, Boston, Mass. 



THE ASSAULT ON HUMANISM 
By Paul Shorey 



The Battle of the Books is as keen today as it was in 
the time of the Renaissance. Within the last decade, 
especially, the forces of the 'old' and the 'new' learning 
have been at full tilt. Under the leadership of Dr. 
Abraham Flexner, President Eliot, and other distin- 
guished members of the 'new school,' practical educa- 
tion has gained an apparent ascendancy, and the 
champions of classical culture have been put on the 
defensive. 

Yet the classicists are not vanquished — not by any 
means; and it is not likely that they ever will be, so 
long as they have such leaders as Professor Shorey. 

The Assault on Humanism is a brilliant offensive- 
defensive on the study of the classics in American 
schools and colleges. So ably does the author marshal 
his forces against the ' Modernists,' so effectively does 
he use his sarcastic wit and his vast fund of learning, 
that his writing in itself is an argument of the first 
order for retaining the study of cultural subjects. 

"We are again grateful to Dr. Flexner. If it had not been for 
his attack upon classical and humanistic culture, Professor Shorey 
might never have written this delightful and inspiring little volume, 
and the world would have been so much — and it would indeed 
have been much — poorer." New York Tribune. 

"Professor Shorey upholds the standard of sound learning and 
literary culture — qualities which are in need of defenders in a land 
where the half-educated are at present more aggressive than the 
educated. Professor Shorey says to his antagonists: 'You must 
not argue that Latin is useless, without discriminating the various 
meanings of utility. You must not tell the public that the science 
of psychology has disproved mental discipline in general, or the 
specific value of the discipline of analytic language study in par- 
ticular. For, if you are a competent psychologist, you know that 
it is false.' " Springfield Republican. 

"It Professor Shorey's literary style, the wealth of information 
which his article shows, the clearness of his analysis, the richness 
and the aptness of his illustrations, are any indication of the results 
produced by the studv of the humanities, he has in this article gone 
far to prove the desirability of a system of education in which these 
humanities have a prominent part." The American School. 

The Assault on Humanism is a charming example 
of bookmaking. It sells postpaid for 60 cents. 



The Atlanitc Monthly Press 

Three Park Street, Boston, Mass. 



PAN-GERMANY: THE DISEASE AND CURE 
By Andre Cheradame 



No student outside of Germany itself has studied the 
Pan-German scheme in all its details more thoroughly 
than the distinguished French publicist who is the 
author of this book. For more than twenty years M. 
Cheradame has devoted his energies and resources, 
physical and intellectual alike, to a vigorous and 
exhaustive investigation of the origin and progress of 
the monstrous conspiracy which threatens to over- 
whelm the liberties of the world. His books, long 
unheeded, now read like prophecies. 

The papers reprinted in this volume originally ap- 
peared in The Atlantic Monthly under the titles, "The 
United States and Pan-Germanism," "The Fallacy of 
a German Peace," and "How to Destroy Pan-Ger- 
many." There they attracted so much attention that 
it was decided to republish them together in inexpen- 
sive book form, so that every American who desires a 
clear understanding of the meaning of the World War 
may have an opportunity to read them. 

M. Cheradame cuts to the heart of the Pan-German 
plot for conquest, lays bare its true significance, and 
prescribes the remedy. He shows that Germany, after 
three and a half years of war, has gained almost all 
that she hoped for, and far more than she expected, 
and that a German peace means almost endless wars 
ahead or else the universal destruction of democracy 
and freedom as we know them. His book should be 
read and pondered by every thinking citizen. 

Pan-Germany is bound in heavy paper and sells at 
25 cents, postpaid. Special rates will be given on 
quantities for patriotic distribution. 

The Atlantic Monthly Press 

Three Park Street, Boston, Mass. 



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